by Gary Davis

Created on: July 01, 2008   Last Updated: July 14, 2008

As the retired Executive Vice-President of a small insurance company I assure you no discussion of medical management, let alone cutting-edge medical management is simple, but, I seem to always be at the doctor so I should have learned something.

If you have been paying attention to the world of medicine then you know that it is no longer run by doctors; in fact it is run by everyone but doctors. Medicine is business and businesses have to change. For maintaining a patient's medical history, the change is a system known as the "Electronic Medical Record" or EMR.

Historically, the record, or chart, of a patient was kept in a folder and filed typically alphabetically. This method was always clumsy. To keep the files in order was physically demanding; it took the doctor precious time to re-acquaint themselves with the background of the patient, but, the biggest drawback was the chance that important papers with respect to drug allergies, past medical history and drug interactions could be misfiled or lost. Beside the risk side of this problem there was the legal side; malpractice.

The EMR is a data storage system that keeps information on every patient with respect to past medical history, family medical history, current prescribed medications, ongoing key monitoring and peripheral notes from doctors in different specialties. If I am an internist, it is nice to have a written report from a cardiologist available to me by simply calling it up on the computer screen.

Two major changes have impacted the medical profession and they are more specific specialties and hospital involvement with respect to management of cost and compliance.

Doctors who try and maintain independent practices these days find they can't keep up. They have to affiliate.

The cost of an ERA system is just like buying a car. You can purchase one anywhere between $16,000 and $33,000. Of course there are always offers of $995 a month and comparable deals; cut-rate dealers if you will, but an ERA is not the place to cut corners.

Doing research, you will find that insurance companies footing the bill are large health insurance companies such as Blue Cross/Blue Shield; Aetna; Progressive and State Farm Insurance. This action is completely self-serving in three ways.

First, immediate access to a patient's records allows a nurse to screen for information pertinent to the visit, so, the doctor can see more patients. Next, the data storage system has everything complete and in order so that there is less chance of a lawsuit for malpractice.

However, the biggest reason for insurance company involvement is simply cost versus results. Whatever they spend, when they compare that to overhead from office operations the savings can be in the hundreds of thousands of dollars.

Make no mistake however; the ERA is good for the patient. It allows an orderly, safe and correct chronological history of their medical history. Historically this unavailability caused a lot of undesired results.

References:

Google/scholar/wang.com
Wikipedia listings of American Health Insurers Follow List

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