Physician Grumbling Preempted

Gary Baldwin, for HealthLeaders News , October 23, 2007

We often hear about how physicians dislike electronic medical record technology. Well, the Marshfield Clinic in upstate Wisconsin has figured out a way around that. For the last two decades, the physician-owned private group practice has been developing its own homegrown EMR. I detailed some of their struggles nearly three years ago for HealthLeaders magazine.

I had the opportunity to catch up last week in person with some staff members from the clinic. Justin Starren, MD, director of Marshfield's biomedical informatics research effort, and Cathy McCarty, PhD, who leads its human genetics research, dropped by Chicago as part of a media blitz (in addition to technology, the 750-physician group also understands PR).

Starren gave me a demo of the EMR software, which uses a blended approach of discrete data, templated information, and what the clinic calls "ink over form." Using handheld tablet PCs, physicians mark on forms right on the computer screen, using a stylus to scribble a note, or mark an "X" on a box. All physicians in the clinic use the wireless system, and Marshfield has managed to retire its paper chart room--which was still a thorn in the organization's side when I first wrote about the group.

Not only that, Marshfield's EMR has been certified by the Chicago-based Certification Commission on Health Information Technology, winning a type of Good Housekeeping seal of approval for technology function. It's a designation sought by commercial EMR vendors--think NextGen, Misys, and so forth--and indeed Marshfield plans on marketing its software to the industry.

As my September cover story pointed out, there are plenty of sales opportunities in ambulatory clinics, as the vast majority of physician groups have yet to automate their record-keeping. Marshfield has already sold its EMR to Ministry Health Care, a competitor health system based in Milwaukee. Whether the Marshfield EMR will ever become a fixture in other physician practices remains to be seen. But if, as the stereotype goes, physicians only listen to other physicians, they may have an advantage.

At least they've figured out how to get the members of their own group to use the EMR--the discussion we had centered on the clinic's advanced research and personalized medicine projects. Starren showed me a scatter chart that graphically portrayed where patients fall on quality metrics. Such features may resonate with physicians far more than the merits of electronic data exchange, however valuable it is.

Gary Baldwin is technology editor of HealthLeaders magazine. He can be reached at




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