The Reason Why: Connected Health Tools Should Come Before EMRs

Within the administration's health reform agenda, its strategy for modernizing the healthcare system by sponsoring a widespread implementation of EMRs is admirable, and necessary, but also terribly insufficient.

There are several reasons for this, not least is the practical reality that the bulk of physicians who would benefit most from this technology -- independent doctors working in small practice groups of two or fewer – cannot afford to implement a modest $300,000 EMR system, even with the administration’s $40,000 subsidy. This is especially problemtatic because at least 33% of the nation’s roughly 820,000 licensed physicans work in such small practice groups.

The very ugly truth is that even where physicians can afford to implement an EMR, evidence that an EMR alone can improve population health or cost-efficiency is lacking.  In fact, the evidence suggests that without concomitant payment reform, an EMR roll-out will merely increase the cost of care. 

So this begs some questions:  1) How big a contribution to our reform effort can an EMR roll-out have if only specialists, large practices and hospital systems can afford to particpate?  2) At a time when federal resources are scarce, is this the best use of $36 billion in taxpayer funds?  3) If EMR adoption or universal coverage are pursued without payment reform, how will we decrease our overall cost of care?

The good new is that there are alternatives to a full scale EMR implementation, namely, “connected health” tools.