It's no surprise to me that the "usability of [physician office] EMRs doesn't appear to be the focus of the federal government when establishing meaningful use standards and certifying products.' I am sure that such standards were largely developed by government officials, vendors, EMR consultants, and organizations such as HIMSS with hardly an end-user physician in sight.
Problems with the reliability and utility of electronic medical record systems has caused hardships for some small physician practices -- costing them tens of thousands of dollars and limiting access to patient care. The House Small Business healthcare and technology subcommittee gathered testimony from some of these physicians [in a recent] hearing. Financial, legal and technological barriers have prevented smaller physician practices from investing in EMR technology....Witnesses told the House panel they were concerned that barriers to adopting EMRs are so great that federal Medicare and Medicaid incentives, which can go as high as $63,750, would not be enough to offset costs and entice the remaining physicians to abandon paper records....The American Medical Association has lodged concerns regarding the implementation ease and usability of EMR systems....The cost and time required to implement EMRs are big obstacles for small practices, said Andy Slavitt, CEO of the health information technology company OptumInsight [formerly called Ingenix]....Some may point to the meaningful use criteria for EMR incentives established by the Dept. of Health and Human Services as being part of the problem. However, questions regarding implementation aren't so much about whether these standards are right or wrong, but about what should be the focus when EMR vendors design systems, [he] said. "What is important is that today the end users, doctors and patients, are further away than ever from system design, because new product development is focused on satisfying those regulatory hurdles, rather than on simple innovations that improve productivity," he said...."As long as [EMRs] are designed principally around a set of needs in Washington and at [CMS], it is a long shot that the technology will provide the simplicity and productivity benefits at the heart of driving real adoption," Slavitt said.
I can't state the case any more clearly than this last sentence in this excerpt: Office EMRs are designed principally around a set of [preceived] needs in Washington and at CMS. Small physician office practices are, first and foremost, small businesses. No small business that is interested in surviving would invest in an IT system that was too expensive and did not support its operational needs. The private physician is a dying breed (see: More physicians leaving private practices ). The governmental emphasis on the adoption of ill-designed office EMRs will only serve to accelerate the process of physicians moving to salaried hospital positions.