Saturday, June 20, 2009

Miller & Tucker on Incentives of Adopting Electronic Medical Records

Amalia Miller (Virginia-Economics) & Catherine Tucker (MIT-Management Science) have posted to SSRN Electronic Discovery and Electronic Medical Records:  Does the Threat of Litigation Affect Firm Decisions to Adopt Technology?  Here is the abstract:

After firms adopt electronic information and communication technologies, their decision-making leaves a trail of electronic information. We ask how the threat of litigation affects decisions to adopt technologies that leave more of an electronic trail, such as electronic medical records (EMRs). EMRs allow hospitals to document electronically both patient symptoms and health providers' reactions to those symptoms. We find evidence that hospitals are a third less likely to adopt electronic medical records if there are state laws that facilitate the use of electronic records in court.


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Electronic Medical Records - patients are being asked to sign electronic forms and will thus be held to validity of the form's contents even though the data therein may not be correct. This is not simply a theoretical problem. Just yesterday when checking into a medical office, I had 2 issues with medical records devices. First, the receptionist turned the electronic device to me and told me "just sign here." I asked what was on it and he said vaguely, "oh, just that you are here for services." I told him I needed to read the form and he rolled his eyes and sighed. The form included various policies and procedures the receptionist had not mentioned as well as the patient's agreement to pay amounts not reimbursed by insurance. Then, the MRI technician brought me into the MRI anteroom. He and I were standing at a desk, he asked me some medical history questions and leaned over to tap my responses into an electronic device. (He wore glasses and appeared to have difficulty reading the dim, small screen.) He then said, "sign here." I asked him what was on it and he said "just your answers to the questions I just asked you." I told him I needed to read it which appeared to exasperate him. Upon reading the form (the entirety of which does not show up on one screen thus necessitating scrolling up or down), I saw that there were several questions the technician had "helpfully" answered in the negative although he had not asked me those questions, incorrectly noted "yes" to whether I had had neck surgery, and incorrectly noted which arm I had had surgery on. Even while "correcting" these mistakes, the technician changed his original error of "rt" arm to "rlt" - leaving a very ambiguous result. No paper copies were provided to me. Although I persisted in having the corrections corrected, not everyone will do so, especially when you are asked to sign the device while standing at a counter and busy administrative personnel want to move onto the next task or person. Not giving people an opportunity to review the forms and input their own responses is going to result in massive amounts of bad data forever following the patient. And think of the evidentiary consequences of having obtained the patient's electronic signature confirming that bad data.

Posted by: Kerry Connolly | Jul 1, 2009 5:10:23 PM

Technology in health care I think will definitely lead to better care.I think with emr or computerized records,we can avoid dangerous medical mistakes, reduce costs and improve care.

Posted by: cardiology emr | Mar 11, 2010 6:54:25 PM

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