In 2009 Congress passed the American Recovery and Reinvestment Act which included The Health Information Technology for Economic and Clinical Health (HITECH) Act. A part of the HITECH Act was to promote the meaningful use of electronic medical records (EMR). Meaningful use is the set of standards defined by the Centers for Medicare & Medicaid Services (CMS) Incentive Programs, and governs the use of electronic health records to achieve specified objectives. A primary goal of meaningful use is to allow access to complete, and accurate, medical history for medical providers as well as patients. One of the ways that CMS has used to encourage the implementation of an EMR is by paying incentives to providers for using an electronic medical record in ways that met the meaningful use objectives. Despite this incentive plan, electronic medical records are in varying stages of implementation in healthcare facilities across the nation. The response of physicians, and other health care professionals, to this technology has also been varied, and this is due in part to the gap between what policy makers consider an effective measure of meaningful use, and what providers consider as meaningful use of an electronic medical record. The needs of the individual users, as well as the ability to customize based on clinical specialties, are key elements to a successful EMR implementation that are not always included, but can have a significant impact on the utilization of the system. The benefits of an effective electronic medical record make it necessary for organizations to overcome these barriers to implement effective electronic medical records that do encourage meaningful use of these systems.
One of the reasons for the inconsistent acceptance of an EMR is due to organizations not taking the nuances of individual specialties into consideration when selecting and adopting an electronic medical record. Dr Michele C. Lim, MD, an ophthalmologist with the University of California described the benefits of an EMR as providing “instant access to patient information, the elimination of illegible handwriting, improving communication with other health providers or patients, and reducing medical errors and adverse events” (as cited in Groves, 2010, p. 41). These are all benefits of an EMR that can expect to be experienced across clinical specialties. However, another ophthalmologist, Harry A. Quigley, MD, with Johns Hopkins University School of Medicine, cited ophthalmology as an example of a specialty that faces “resistance from administrators who want to ‘shoehorn’ ophthalmologists with other specialists and assume that it is no problem for everyone to use the same EMR format” (as cited in Groves, 2010, p. 42). Ophthalmology, as do other specialties, has a number of unique tests that may require customization, or a completely different electronic medical record than the rest of the organization, and that needs to be considered when designing an EMR. These clinical...
