“The report, Electronic Health Record Use and the Quality of Ambulatory Care in the United States, appeared in the July 9 edition of the Archives of Internal Medicine, and concluded quite bluntly that: “As implemented, EHRs were not associated with better quality ambulatory care.”

Written by prominent health information technology figures from Harvard Medical School and Stanford University, the study examined records of 50,574 patient visits collected as part of the National Ambulatory Medical Care Survey in 2003 and 2004, and compared how physicians with and without EHRs did on 17 quality measures. The researchers concluded that EHR-using physicians had significantly better scores on only two quality indicators, had no significant difference on 14, and did significantly worse performance on one.”

PHR is even more likely to fail for two reasons:
1. Below 40-50, healthy individuals wisely avoid doctors and hospitals.
2. People prefer not to think about needing a doctor or hospital as that is one step away from mortality.

Chronic patients, infuriated with the inept and inefficient process of heath care documentation can attempt to provide quality data… but unless the material is printed, 99.9% of all intake points will refuse it.

The naiveté of attempting to compete against a Google or a Microsoft (or a WalMart/Intel or WebMD/Version, or a Steve Case) is staggering. All business comes down to the top three and the rest don’t really count. When the smoke clears, Google and Microsoft will own the market and the others will be bought out or bankrupt.

“Standards” are a joke. When Google and Microsoft prevail, they dictate the standard and anyone who doesn’t realize that is how the digital world works has been asleep for the last 20 years.

The medical documentation issue will be resolved only when a single payer system forces the adoption of a format not unlike that of coding care for insurance purposes. Is that an ideal solution to documentation… no, however, it’s light years beyond the ad hoc gibberish that passes for medical records today and a much better approach than the tower of babel being hustled by hundreds of vendors.

The best counsel to a physician today regarding EMR/PHR/EHR, etc. is keep doing whatever you are doing. Chances are about 90% in your favor you will save time and money and be no worse off than you will wasting it on a panacea.