There’s a debate raging in the medical community about electronic medical records (EMRs). On the one hand, we have success stories like Kaiser Permanente, which completed an award-winning system-wide rollout this year of the world’s largest private sector electronic health record. On the other, we have news that just broke in the last days of 2010 that suggests EMRs are not always linked to improved care in hospitals.

Electronic Medical Records Are Our Future—But Will They Improve Our Care?

In terms of future direction, there’s little doubt that the use of electronic records will continue to proliferate in the healthcare industry, spurred by Obama’s 2009 legislation which may provide as much as $30 billion in federal aid to hospitals that go electronic. For facilities that are able to emulate Kaiser’s transition to a nearly paperless environment, the rewards could be great, both for staff and for patients. According to CNET, Kaiser reported an increase in patient satisfaction, along with a small dip in hospital stays and visits to the emergency room, in conjunction with their digitization. This helps to relieve the burden on providers while cutting costs.

Kaiser’s secret weapon is called “KP HealthConnect.” It’s a comprehensive system that connects Kaiser’s more than 8.6 million members to both their healthcare providers and to their personal information. The system also helps empower patients to take a greater role in managing their own health by providing electronic access to a personal health record. This gives members access to their lab results, medication information, and health condition summaries. It also allows them to email their doctor, cutting down on office visits and waiting-room time. Kaiser has documented more than 27 million log-ins to the system in 2009 alone.

Associate executive director at The Permanente Federation, Andrew M. Wiesenthal, MD, SM, reported in a Kaiser press release that “[I]t is extremely rewarding to have watched an idea, that was questioned by many, turn into a reality.” However, what’s worked well for Kaiser may not be so easy for other organizations to emulate. CNET points out that the rest of the healthcare system “looks nothing like Kaiser” because Kaiser provides medical services but is also an insurance provider. Most hospitals don’t operate like that.

Additionally, a new study published online in the American Journal of Managed Care (December 22, 2010) shows that even hospitals that do get EMRs up and running may see little or no improvement in quality of care. Researchers at RAND Corporation studied more than 2,000 hospitals across the United States. They found that although hospitals with basic electronic health records saw an increase in quality of care for heart failure patients, that same increase was not seen for patients being treated for heart attack or pneumonia. Gains were also not noted among hospitals that upgraded to more advanced systems of EMRs.

Although the study’s lead author Spencer S. Jones worries that the disappointing findings may suggest that the right measures weren’t tested to accurately evaluate the effectiveness of health information technology, these results reemphasize what many detractors of EMRs have been warning all along: there will be no easy path to reach the seamless system that both doctors and patients alike would love to see.