Parent either is full of it or lives in a parallel universe. 1. Cost is not a barrier? Our EMR costs each physician many tens of thousands a dollar a year in application support, licensing, databases, and for a phalanx of IS personnel in various departments (local, regional, EMR, hospital IS). 2. MD's have a monopoly? What planet are you on? DO's have had precisely equivalent standing for decades in medical practice in the United States, and NP's are far from being "wiggled in." As a primary care physician, when I send a patient to the cardiologist or pulmonologist, half the time the entire consult is done by a PA or NP. 3. Please direct me to the land you describe where I can have control over my care environment and take home most of the money. I can't get a contracting pregnant lady into labor and delivery without asking for permission from two nurses, and I'm not aware that the balance of power in any health system I've worked in has been any different before and after transition from paper records. Medical care in most locales in the US has long been collaborative, team-based system, even if you've met a few physicians who are jerks or drive nice cars. (I am looking forward to upgrading my '94 Corolla by 2014.) EMR systems have poor market penetration, in my direct experience over the last 9 years, because: 1. Many, if not most, suck in a medium to large way; 2. They are incredibly expensive; 3. They can often be hard to use, and are typically more labor-intensive than paper charts for most physicians in the US; 4. They don't inter-operate. (When I request old records from other physicians with electronic charts, I enter the pertinent data into my electronic chart by typing it in.) If any skilled group of software engineers were to write a decent, usable EMR that was extensible, and didn't cost an arm and a leg, with an eye to being excellent first and profitable as a consequence, they could be up for a Nobel prize. TFA refers to cardiac CT to prevent heart attacks. The author, too, lives in a dream world - contrary to her thesis, this test has been shown to help with the boat payments of radiologists and equipment manufacturers, but there is no evidence it helps prevent heart attacks.
Ok, You wrote my comment for me. But I'll add my bit. My background is Chemical Engineer, Internal Medicine (because they were easy and fun to study), then Emergency Medicine (because it was fun to do) for the past 30 years. During that time I was mostly in direct patient care but did have various administrative duties. Naturally, as a Slashdotter I had a continual involvement with computers. After evaluating numerous awful EMR systems for our hospital I checked to see why. Generally there was little clinical input at the levels that mattered, but I agree it is harder than it looks to do it right. Getting long in the tooth for the ER, I thought to apply to some of the software companies for employment. The response was, "We only have openings in marketing." I second all the comments here regarding lack of any conspiracy. None of us are that good.
You must realize that the computer has it in for you. The irrefutable proof of this is that the computer always does what you tell it to do.
