EMRs in the stimulus bill

The much-debated stimulus bill that will be juggled between the Senate and the House this week includes some impressive provisions that could potentially have huge impacts on American health care. First, $20 billion have been provisioned for incorporating digitized medical records (or EMRs, electronic medical records) into doctors' offices. This should be applauded as packing a much-needed punch behind words that have been touted since the Bush administration. But even advocates and experts in the health IT field are cautious, as they well should be. Our health care system became the way it is due to a series of haphazard legislation, incremental compromises between interest groups, and a focus on treating disease rather than preserving holistic wellness. EMR systems are an essential part of elimited the poor quality and high cost of health care because they reduce framentation of care in our current system. The problem is not that we lack the technology, the cost-cutting incentives, or now even the funding. The stimulus money will hopefully lay some important ground work to putting into place technological infrastructure that will bring health care up to the standard of other industries. The problem, as usual, is that we lack planning. We don't have an organized approach for how the money we're spending today on EMRs will lead to increased coordination of care and communication between providers, patients, and payers in the years to come. Obama and his health care team will do this country and the future of health care a huge favor by using the stimulus as an opportunity to reshape health care IT. The money should be earmarked for organizations that are willing to share, instead of silo, their technology and expertise. The stimulus plan should also favor organizations that stand to gain the most cost reduction and quality improvement, namely larger, more complex systems, from having EMRs. Smaller group practices and individual providers in rural areas should definitely not be left out, but it is not cost-effective to fund individual EMR implementations for these providers. Instead, they may be allowed user privileges in larger EMR systems nearby, where they may already be allowed referring physician access. Obama has proven how he can use vision to inspire action; with the stimulus bill, he should using the tools at his disposal to drive synchronized action towards a more transparent and coordinated health IT system.