Electronic Medical Records: Podiatrists Lead in “Meaningful Use”

Today’s Managing Health Care Costs Indicator is 12%

Many have suggested that electronic medical record adoption will help physicians lower medical costs. The hypotheses about how EMRs will lower medical costs include:
·        Better coordination, so that physicians won’t inadvertently prescribe conflicting medications or order duplicate tests
·        Better decision support, with fewer medical errors and adverse drug reactions
·        Better patient communication, with portals to allow for questions and some self-service requests.

EMRs could lead to lower drug costs, fewer hospital admissions and readmissions, and even decreased use of the emergency department.   Of course, EMRs will only accomplish this if they are fully functional and actually used! 

Electronic medical records are likely to have the most impact when they are implemented by physicians who take care of complex patients – those who are cared for by multiple different physicians in different specialties, who are often on polypharmacy as well.

So what specialty is leading the race to adopt electronic medical records and meet federal “meaningful use” guidelines.  Here’s a disappointment.  It’s foot doctors, who make up 1.5% of Medicare clinicians, but had 12% of the federal ‘meaningful use’ payments.

Podiatrists often take care of especially sick people. Their practices tend to have many frail elderly patients, and many of these have diabetes or vascular disease.  However, podiatrists don’t prescribe an especially broad range of pharmaceuticals, and the level of coordination required between podiatrists and other clinicians is on the low side. 

It’s great that podiatrists are implementing EMRs and doing it well.  However, we’ll get the most value from EMRs when internal medicine specialists such as cardiologists and nephrologists are adopting EMRs at this kind of level.