By eliminating those options that Halamka alluded to earlier, the cost of interfaces between the remaining disparate systems will drop from thousands of dollars per interface to hundreds of dollars. "There's still customization, but it's minor."
Although everyone speaks of meaningful use as a platform upon which to build tomorrow's innovations in medicine, there are complaints today about the lack of ease of use of EMRs.
"The cost to us in lost efficiency by implementing a health information system is somewhere between $300,000 and $750,000 in the first year," says Prentice Tom, MD, chief medical officer of CEP America, an Emeryville, Calif.–based provider of hospitalist services that sees 4.5 million patients annually.
To make up for the inefficiency, CEP hires scribes that cost about $27,000 per physician annually.
EMRs would be adopted more rapidly, and wouldn't require as many government incentives to acquire, if they included algorithms that present the useful information out of the record, Tom says.
"It's a fair indictment," Halamka says. "If it takes 47 clicks to write an e-prescription, as opposed to one click to order a CD on Amazon, something's wrong." Future meaningful use rules will require "some measure of usability" to address this, he says.
"The conversation has really got to be more about value for the money we are spending," Mostashari says. "Electronic health records are a necessary, though probably not sufficient part of that equation."
This article appears in the August 2012 issue of HealthLeaders magazine.