EMRs? We don't need no steenkin' EMRs

A survey of over 2,700 physicians by the New England Journal of Medicine shows only 4% make full use of Electronic Medical Records (EMRs) and barely one in eight has even a rudimentary system.

(Alfonso Bedoya played Gold Hat, who needed no steenkin' badges, in The Treasure of the Sierra Madre.)

The problem is centered on small practices. Half of all practices with 50 or more doctors are now computerized.

Still, the authors concluded, " Physicians who use electronic health records believe such systems improve the quality of care and are generally satisfied with the systems."

The reason for the lack of steenkin' EMRs, The New York Times suggests, is cost. One New Jersey doctor interviewed by the paper estimated that cost at $15-20,000, then doubled it, assuming productivity would decline while it was being put in.

Medicare has recently launched a $150 million project to get 1,200 small practices online, with doctors getting up to $58,000 over five years to make the move, the paper noted.

Without EMRs controlled by physicians, of course, there is nothing on which a patient can base a reliable Personal Health Record (PHR), which might be stored at Google, Microsoft, or on a stick memory with your keys. You might get some basic information on there, about your medications, but no detail.

While most critics continue to insist that technology innovation and new business models will solve the problem I'm not so sure.

EMRs and PHRs are a control issue. Once a doctor has an EMR, and the patient a PHR, the doctor can quickly lose control of the customer.

Sometimes, survey says what survey writer wants survey to say.