Senator Grassley: You’re on Track About EMR Problems, But Here Are Some More Questions to Ask

An article in today’s Washington Post links to a letter written by Senator Charles E. Grassley.

The letter is directed at 10 EMR (electronic medical record) vendors, and asks very pointed questions about whether the vendors have been negligent in not addressing patient safety issues in their technologies.

Senator Grassley, you have the scent and you’re on the trail.  There are several other questions you should be asking these vendors:

  • Prior to the HITECH Act, why did EMR vendors promote and government policy tolerate non-interoperable EMRs?  Health care isn’t like computer operating systems — where competing, non-interoperable tech is fine.  Lives are at stake. 
  • Why is the failure and de-install rate of EMRs so high?
  • Why have EMRs cost so much?
  • Why have vendors paid so little attention to the usability issue…even HIMSS’ recent study acknowledges the seriousness of this problem.
  • Why is the government favoring payment for EMRs over other equally promising or more promising technology.  From the Nutting report, Initial Lessons From the First National Demonstration Project on Practice Transformation to a Patient-Centered Medical Home:

…[I]t is possible and sometimes preferable to implement e-prescribing, local hospital system connections, evidence at the point of care, disease registries, and interactive patient Web portals without an EMR.


Graphic from Lyle. Berkowitz MD, Improving EMRs PowerPoint, April 2009


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