The Electronic Medical Record: Promises and Pitfalls

Jacob Reider, MD

In This Article

Could This Be the Answer?

There are several efforts under way that may significantly affect EMR adoption by creating such a national endeavor. The first is the National Health Information Infrastructure (NHII), "an initiative set forth to improve the effectiveness, efficiency and overall quality of health and health care in the United States."[6] Although it is in its infancy, the NHII may play a pivotal role in fostering EMRs by providing incentives to physicians who use EMRs, or incentives to vendors who develop products that meet the standards of safety and quality that NHII defines.

With goals similar to those of NHII, The National Alliance for Primary Care Informatics (NAPCI) is being formed by several of the primary care member organizations and the American Medical Informatics Association (AMIA). Since the majority of outpatient visits in the United States occur in primary care offices, NAPCI's goal is to provide a single voice for primary care, so that the needs of these providers and their patients can be understood and addressed by vendors, government, and insurers.

The American Academy of Family Physicians (AAFP) is leading an effort to form a public-private consortium whose goal is to distribute and maintain an open-source EMR.[7] By removing some of the traditional cost, training, and workflow issues, AAFP hopes the open-source EMR project will lead to faster adoption of this technology in family practice and other office-based medical specialties.

With all of this excitement from key constituencies, it is now clear that the EMR is in our future. The key questions, then, are: when, which, how, and -- most important -- how much will it cost?