Dr Shepherd rightly observes that the physicians’ statements in the September article were testimonials to the benefits they have experienced with EMR. As the CMAJ articles acknowledged, physicians’ individual experiences with how they use their EMR vary significantly, even between users of the same EMR product, so it is important that we recognize and learn from the experience of those who are reaping the rewards of their efforts.
There are many physicians who are happy to demonstrate the impact their EMR has had on patient care using objective data directly from their EMR—such as measuring how control of certain clinical indicators has improved with closer monitoring made possible by the EMR.
However, measurement of the broad impact of EMR on patient outcomes is challenging because it is difficult to distinguish the degree to which those improvements have occurred as a result of the EMR rather than concurrent changes in the health system. This challenge is compounded because most physicians have been on their EMR for less than 2 years and therefore have not yet captured enough data for analysis.
PITO and a number of BC physicians are participating in a national study of the impact of EMR and we anticipate publishing those results in 2012.
As for the EMRs themselves, those that are widely used in BC existed prior to government-funding programs. In fact, five of the eight EMRs that represent 92% of the BC market were founded and/or developed by physicians; the other three were developed with active physician involvement.
The EMR certification process here in BC extended that philosophy by establishing a group of practising physicians and medical office assistants to independently assess the software for clinical usability.
PITO Program Director
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Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.
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