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American Medical Association

No surprise doctors dislike electronic health records

Mike Feibus
Special for USA TODAY

If there was a wearable that could alert you and your doctor if you were in danger of having a heart attack, would you want it?

I sure would. But apparently, not everyone feels the same way.

Take Dr. James Madara, CEO of the American Medical Association, for example. Earlier this month, he took time to rant about how technology is overrunning healthcare in his speech at the AMA annual meeting in Chicago.

“From ineffective electronic health records (EHR), to an explosion of direct-to-consumer digital health products, to apps of mixed quality,” said Madara, according to his prepared remarks, "this is the digital snake oil of the early 21st century.”

Certainly, much of the U.S. healthcare system now has electronic health records. And it’s largely ineffective.

According to a survey released early this year by HIMSS, a health IT trade group, only 29% of physicians report positive benefits from electronic health records. And an AMA survey found that nearly one-half of physicians report implementing the technology has resulted in a higher costs, lower productivity and reduced efficiency.

So it’s not hard to understand why many healthcare providers have a jaundiced view of the technology, and why they bristle at the notion of funneling oceans of remote patient monitoring data into the system.

Caregivers resist

To the extent that electronic health records have been ineffective, I believe it’s due more to a failure of our system of care than it is of the technology. Because while most facilities met their obligation to install electronic health records, few have embraced it.

I can tell you that from personal experience.

Recently, I got an email from an outpatient facility asking me to input my medical data into their system. This was weeks ahead of a planned arthroscopic procedure. I dutifully took the time to gather the information and enter it into it the portal. So I was surprised a couple weeks later when, during my pre-op appointment, the doctor asked me what meds I was taking. And then, just after surgery, he gave me pictures from the procedure and told me to bring them to my follow-up appointment so they could explain to me what they did.

People with diabetes often use a blood glucose monitoring device to help them maintain healthy glucose levels.

So much data. So little access. I’d have to agree, that’s pretty ineffective. It’s also pretty common.

I do understand why some healthcare providers resist electronic health records. Change is difficult. And time consuming. They already have taxing jobs. They’re busy, stressed. And they may have a bad taste in their mouths from previous forays into technology.

But guess what? Sooner or later, they will have to take the plunge, and incorporate the technology into their workflow. And they will have to incorporate remote patient monitoring devices into the records. Because wearables, connected scales, glucometers and blood-pressure cuffs will be what give healthcare professionals the insight they need to make better decisions.

The practice of medicine urgently needs to make better decisions. Because the $3 trillion US healthcare system is beginning to bow under the weight of an aging population that needs increasing care and attention. It will only get worse if they don’t get better.

Think about this: the meteorologist on the Weather Channel has far better tools at her disposal to forecast whether it will rain on your upcoming trip to Boston than your doctor does to assess whether you might need medical attention while you’re away.

Let that sink in for a second. The meteorologist has sophisticated, self-adjusting computer models, fed by streams of data from satellites, weather balloons and weather stations that detail temperatures, atmospheric pressure and the state of approaching systems.

And your doctor? All she has to go on are a few bloodwork reports, a few sets of vital signs recorded during your office visits and some insight you’ve chosen to share in the examination room – accurate or no. In climatic terms, it would be like forecasting rain armed with little more than yesterday’s highs and lows.

To make the best medical decisions, physicians need insight gleaned during the eleven months, 29 days and 22 hours you’re not in their office each year. Insight akin to what meteorologists have. Fortunately, that’s starting to come.

It’s coming in the form of stick-on patches, injectable biosensors and smart clothing, They’re typically paired with companion hardware, smartphones apps and cloud services to monitor the steady stream of data, make suggestions for improving the results and notify caregivers at the first hint of a problem.

In the past few weeks alone:

  • Medtronic and Qualcomm announced they are partnering on next-generation continuous glucose monitors, or CGMs. A CGM pairs a monitoring patch with a device that constantly records blood sugar levels, giving diabetics and their caregivers much finer control over their condition.
  • Startup VitalConnect unveiled VitalPatch, a stick-able device that continuously monitors heart patients’ condition. The device has been tested in Europe and is beginning trials in the US this summer.
  • Startup Profusa announced the Lumee, an injectable biosensor that sits in the tissue just underneath the skin and a companion reader to collect measurements from the device. The first product is called the Lumee Oxygen Sensing System, which will be available in Europe later this year to help monitor recovery after vascular surgery.

Devices like these, I believe, will prove to be the Doppler Radar of medicine. Because what they bring to the practice of healthcare is a healthy injection of insight.

That’s not snake oil. It’s science. And it’s long overdue.

Mike Feibus is principal analyst at FeibusTech, a Scottsdale, Ariz., market strategy and analysis firm focusing on mobile ecosystems and client technologies. Reach him at mikef@feibustech.com. Follow him on Twitter @MikeFeibus.

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