A free market is the most powerful economic force on earth. According to Adam Smith’s The Wealth of Nations, this is because free markets let people make informed purchase decisions based on how products further their own interests. If left to operate without interference, a truly free market rewards products that consumers deem superior, and puts companies with inferior products out of business.
However, informed purchase decisions can be made only when unbiased information is available. Currently, in the EMR market, such information about the myriad of product offerings is largely absent, and purchasers must rely on unauthenticated vendor claims. It’s no wonder that physicians are reluctant to purchase these expensive systems—the risk of a financial disaster looms over their heads.
The barriers to EMR adoption are not problems that government incentives can even begin to remedy. What is needed to truly drive adoption is major healthcare IT reform. Transparency and full disclosure must be introduced in order for market forces to work and for widespread adoption to occur. Just imagine the effect of the following EMR reform proposal:
|1.||Increase the EMR success rate (and reduce the lamentable failure rate) by increasing product quality and usability through competitive benchmarking.
Physicians should have access to “click” comparisons that measure the efficiency of each EMR in conducting common office workflows—finding a chart, reviewing chart information, sending a message, creating a problem list, creating a prescription, signing off on a lab, or ordering a test. These comparisons would create a race to efficiency as vendors are forced to think about physicians’ workflow and productivity, and would ultimately create more usable, superior products. After all, which vendor would want to be known as the most point-and-click-heavy vendor in the marketplace?
|2.||Provide transparency by issuing audited vendor report cards.
A report card would measure each vendor’s previous three years of sales and their success/de-install rate by specialty. In the auto industry, the information available through crash-test results and the J.D. Power and Associates consumer-satisfaction reports give manufacturers the motivation to build cars that meet consumers’ needs and preferences. EMR purchasers should have similar quality data enabling them to make successful choices as well. KLAS has laid the important groundwork with their customer-survey-based comparative EMR data, but additional data from objective tests and non-vendor-selected customers would round out the picture.
|3.||Take the systemic risk out of purchasing an EMR by allowing providers to return EMR licenses if they do not perform as promised—in other words, an EMR Lemon Law.
A return policy would profoundly and positively impact adoption rates since physicians would be less likely to fear being victimized by false sales pitches, and vendors would be more likely to ensure that implementations went smoothly. It would also ensure that products not appropriate for a particular specialty would not be sold to those physicians.
These simple healthcare IT reforms will level the playing field and restore the sorely needed balance between vendors and physicians. The result will be faster, more confident purchase decisions and increased long-term adoption.