Wednesday, June 25, 2008

Electronic Medical Records, Internet, Limits of Technology - EMRs and Consumer-Internet Use

I have a confession to make. I don’t use ATMs. I don’t shop online. I don’t deposit online. I don’t go through electronic shopping center check-out counters. I don’t seek out doctors with EMRs for my personal care.

The New York Times, that fount of national health system wisdom, disagrees with me. In a June 24 editorial, “Our Pen-and-Paper Doctors,” the Times opines that every American doctor ought to have an EMR, just like doctors in Australia, New Zealand, the Netherlands, and Denmark do. The Times cites a Mass General survey of 2700 doctors and laments that only a “paltry” 4% of doctors have “fully functioning” EMRs. The Times concludes, “It is time to drag private physicians out of the paper age.” Presumably public doctors, bought and paid for and supported by government, would have EMRs.

In fairness, the Times does mention that American doctors think EMRs cost too much to buy and maintain, don’t fit their needs, and become rapidly obsolete. What the Times doesn’t say is that studies to date in the U.S. indicate no significant differences in quality, safety, outcomes, and productivity in doctors with or without EMRs.

Nor does the Times say anything about consumer Internet attitudes and actions. Surveys indicate consumers would like to communicate with doctors by e-mail and regularly surf the Net for information about signs and symptoms and treatment of disease.

But, as it turns out, consumers don’t pay much heed to doctor rankings and choosing a doctor. According to a 2007 survey of 1007 California adults, only 1-2% use doctor online rankings to choose or change doctors. Consumers prefer word of mouth referrals from friends, relatives, and neighbors and personal stories. When it comes to choosing doctors, the Internet is not yet that Great Global Positioning (GPS) in cyberspace for steering , influencing, and telling patients where to go for care.

I suppose it is contrary, ornery even irreverent, for me question the notion that this nation’s health system and its doctor choices, are not yet ready for e-prime time, or that our medical system doesn't have to run on Internet time, or that myself and 98%-99% of other consumers, still prefer to choose caregivers the old-fashi0ned way, word of mouth and local and regional reputations, rather than Internet rankings, but that’s what blogs are for – to keep readers and the Times in touch with reality.


1. New York Times editorial , “Our Pen-and-Paper Doctors,” June 24, 2007.

2. Pamela Lewis Dolan, “Patients Rarely Use Online Rankings to Pick Physicians,”, July 23/30, 2008.

3. California Healthcare Foundation, “Just Looking: Consumer Use of the Internet to Manage Care,” Harris Interactive Survey of 1,007 adult Californias form Nov. 5 to Dec. 17, 2007

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