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Alan Pelz-Sharpe

Electronic Medical Records - No Slam Dunk

11-Mar-2009

Tags: , Document Management (ECM), E-mail Archiving and Management, , Building Business Case, Implementation, Selecting Technology

Here in the US, the topic of electronic medical records has popped back to the top of the agenda, due to an impending mass injection of government money. Long talked about, long promised and long mandated (remember HIPAA?) -- electronic medical records in the US are for all intents and purposes still a pipedream. Yet as a late adopter (to put it politely) the US can potentially benefit in part from experiences in UK and Europe in general.

The UK has long been pushing the benefits of and investing heavily in electronic medical records -- yet the slam dunk that the new administration seems to expect in terms of benefits has yet to be realized elsewhere. To explore why takes us into a range of big and complex ECM topics, but we can focus in on two key areas that will without doubt tax the new administration as they move forward with their initiative:

1) It is assumed that moving to electronic records will by default deliver efficiency and cost benefits. Yet nobody seems sure how to quantify these benefits. I was always taught that assume makes an "ass out of u and me," and that may be the case here. Systems that have run relatively efficiently for generations are not so simple to replace and improve upon. Cost benefits may in fact in many cases be non-existent. Indeed you would be hard pressed to find anyone involved in the UK's NHS projects that would be able to point to measurable cost savings, and when people tell me that such savings are impossible to calculate, then I don't believe them.

B: Patients are highly sensitive to two things -- errors and privacy. Errors, when they are digitally generated can often be harder to deal with than plain old analog errors. An incorrect electronic record can persist far longer and be replicated far more often and more easily than its analog equivalent. I'm not sure about you but I don't want errors on my medical record. I also don't want anyone else seeing my records, and again it is often far easier to find unprotected confidential electronic records than hard copy alternatives. Newspapers in the UK currently feed off the latest electronic leakage of highly sensitive medical data, and they not short of examples to gloat over.

I am not advocating that the medical industry in the US remains paper based, as I try to keep my Luddite tendencies in check. But I am hoping that most of the promised money (and there is a lot of it) goes into the analysis, re-engineering, and change management that will most certainly be required to take such a highly complex and deeply embedded set of information systems and move them to the digital age. A rush to buying technology from document and records management vendors will result in yet another appalling mess for sure.

The money is there to do the job properly, but ECM is 20% technology and 80% process. And despite project failure after project failure, that basic concept has not been grasped by the majority of buyers. This time round though it is personal, it is public funds, it is complex information management, it is highly confidential, and lives depend on its accuracy, so it has to be done right, or not at all.