Greed. Pure and simple. That is what has killed electronic medical records.
It's anywhere from $60,000 - $100,000 for an EMR system. And if your EMR of choice doesn't do practice management, you have to spend another $10,000 - $20,000 for that.
The big promise of EMR is data portability. And here's the big secret that no one seems to be talking about: the data *is not portable*.
If I have ABC Company's EMR and you have DEF Company's EMR, I cannot export a patient chart, send it to you and then you import it. You cannot connect to my EMR and get charts for patients I refer to your clinic. So there is no universal patient chart that follows you where ever you go.
Plus, if you *do* have some other electronic system that has to interact with your EMR (say a pathology system or a perscriptions system) you have to pay *both* companies typically $10,000 *each* to do an HL7 link between to two systems. And even then, the link between the systems is spotty at best and half the time doesn't work.
A company that has very little in the way of technology wants to transition to EMR. So they have to spend $30,000 - $40,000 just for the computer hardware (workstations, servers, printers, scanners, routers, switches, etc.) and then another $60,000 - $100,000 for their EMR and practice management needs. THEN, the users have to be trained. I do IT and primarily work with medical offices and sugrical centers. I can tell you that doctors *do not want* to learn how to use computers and software. The office employees fight it, everyone fights it. Eventually they give up and don't use it and let $100,000 worth of hardware and software go to waste because they become too frustrated to use it, it slows them down exponentially and it hasn't made anything easier or more portable. I have seen so many offices basically throw money down the toilet on these EMRs. They get them, and within a month they can't stand them and just go back to paper charts. Not to mention how much they get in the way of patient care. My wife recently went to see the doctor. The doctor was hunched over her computer the whole time and seemed more concerned with making a typo than with paying attention to my wife. Paitent care is suffering greatly.
THEN, the EMR companies want to hold back common sense features and charge you tens of thousands of dollars to implement them. One office I worked with had a web-based EMR and the doctor wanted to be able to recieve faxes right into the EMR. They said sure, you can do that. She asked if they could download and print out the faxes if they needed to. The company told them that yes, they could, but that was an extra feature that would cost $10,000.
Vendor Lock-in is not just something that they strive for, it is the very *core* of the EMR landscape right now.
EMR is a complete and total failure and you can lay that failure squarely at the feet of the greedy bastards who sell it.