Aaron Berdofe, MHI – Health Informatics

Question: Why do you want to implement an ambulatory EMR?

Answers I have received from numerous healthcare provider organizations:

• “Improve patient safety”
• “Enhance communication between providers”
• “Improve efficiency”
• “It’s where the industry is heading” (my favorite)
• “Stimulus funds”  (new in ’09)
• “EMR package offering for local independent physicians”  (new in ’09)

In reality, there have been zero research studies showing that ambulatory EMRs improve patient safety, enhance communication or improve efficiency by themselves.  The most positive studies show reduced infection rates in inpatient settings as well as potentially positive, yet marginal safety impacts for CPOE.  The HITECH act is meant to supplement the cost of implementing an EMR, not give healthcare provider organizations the ability to come out ahead on the deal.  Last, although having an EMR package offering is important, most independent physicians will generally keep their existing allegiances.

Ambulatory EMRs provide one thing: transparent data.  As long as you define what data you want out of the EMR ahead of time, the implementation will be successful.  The single goal of any ambulatory EMR implementation should be to provide the organization with digital mountains of data that can be mined, analyzed and visualized quickly.  The ability to act on this information will translate into an improved consumer experience and a more profitable business.  EMRs are not solutions.  They are tools to make sure you are collecting the data you want.  But defining what you want as an output from any system, electronic or otherwise, is necessary to establish first.