We upgraded for several reasons:

-- Our previous EMR vendor went out of business, necessitating a change.

-- There were financial incentives from a local hospital and from Medicare to upgrade.

-- It was time to upgrade in order to harness the power to provide better care.

But I have lost lots of sleep, worked longer hours and sprouted some new gray hairs as a result.

EMR 101

Electronic health records have existed for almost 30 years, but physicians and hospitals in the United States have been slow to adopt the technology. In 2006, less than 10 percent of all US hospitals had a fully integrated electronic health record system.

Contrast this with Taiwan, where over the last 16 years that country has developed a uniform electronic health record for all its citizens—Taiwanese people carry an encrypted card which stores all of their health information. Imagine! No more forms in the doctor’s office!

In an effort to increase the use of EMRs in the U.S., several groups—including the U.S. Department of Health and Human Services and the nonprofit Certification Commission for Health Information Technology—have worked together since 2005 to standardize how each EMR should be capable of functioning.

With some standardization, and a realization of the improvement over paper charts, there was an uptick in physician offices and hospitals adopting EMRs. But the cost of purchasing a system—tens of thousands of dollars per physician—and the time spent inefficiently installing, learning the software and breaking all the old habits associated with using paper charts prevented widespread use.

In 2008, less than 40 percent of U.S. physician offices used an EMR. (I am proud to say my partners first started using an EMR in 2003; I joined the group in 2008).

In 2009, The American Recovery and Reinvestment Act (aka, “the stimulus”) set aside funds to give incentive payments to physicians and hospitals who care for Medicare or Medicaid recipients.