Should EMRs offer research capabilities?
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Maybe it sounds like a crazy question, but how do you use your EMR system? Are you dedicating it entirely to supporting direct patient care, or do you expect to use it to conduct research, too?
I ask because some comments I've included in today's issue have me thinking. In it, a CDC researcher notes that the so-called "secondary" uses of EMR data--including disease surveillance, quality research and tracking of adverse drug reactions--are far too important to get second billing. Last week, he urged colleagues at at a DC seminar to rethink the whole raison d'etre for EMRs generally.
The question isn't just an academic one. Right now, commercial EMRs are being designed almost exclusively with patient care in mind. Whether that poses obstacles to quality data gathering, public health monitoring or academic research would, of course, depend on the product, but I'm sure it'd be easier to perform these tasks with software that anticipated research needs.
It seems to me that if an institution is going to spend all of the money it takes to bring up a robust EMR--at least $4 billion in Kaiser's case--it'd be crazy not to use it to track care, participate in national efforts to cure diseases and improve drug safety. On the other hand, I realize that there may be something I'm missing here from a design perspective.
OK, now it's over to you. Do you think it's important for EMRs to offer research capabilities, too, and if so how robust should they be? Do you share data with academic or government institutions now, and is it a strain on your systems? - Anne
Comments
I agree that EMRs should be used for research. In the grand scheme, I think they will prove to be more valuable for research. A chronology of treatments and outcomes from a wide population is exactly what the medical profession needs to become more efficacious. However, practical use might prove difficult due to lack of standards and commonality of documentation.
at a meeting last week, Dr. Kolodner discussed the OFfice of the National Coordinator for Health IT and specifically objectives for:
Medical information that follows the consumer so they are at the center of their care, clinical information in the hands of clinicians so that it guides medical decisions, clinicians having appropriate access to a patients' complete treatment history, ordering medications with computerized systems and receiving electronic reminders, quality initiatives that result in robust performance competition, - and to the point of this article - clinical research and care delivery that can be linked together.
Clearly this office is considering the research implications in its planning and development of standards for health information exchange; software companies involved in the development of
EMR tools should keep this office and its objectives in mind in their data modeling and architecting activities.
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