2009 is a year of hope and change. However, it is not certain that change will be positive when rushed through congress at break-neck speed. The economic stimulus bill that President Obama just signed includes legislation that will establish a national computerized medical records database that will contain data on every citizen. In addition, the legislation will force physicians to adopt electronic medical records (EMRs) that meet government standards and specifications.

There are three main problems with this new legislation. First, it eliminates patient choice regarding disclosure of their medical records. Second, it creates a high-value target for online criminals. Third, it eliminates freedom of choice for physicians.

A national database containing data on “every American” by definition proscribes patient choice. Although the legislation states participation is voluntary, it does not contain any measures for opting out of the system. Furthermore, the database will be used for biosurveillance, public health, as well as research purposes. It is unclear what “biosurveillance” means at this time. However, it is clear that any citizen in this data base will have no control over their records.

Online databases of medical information have traditionally been high-value targets for e-criminals. Medical databases are desirable because they usually contain the information necessary to perpetrate identity theft. Additionally, there are many recorded incidents of hospital record systems made available on the internet through poor server configuration or administrative error. The government has a lackluster history regarding computer security. The Federal Information Security Management Act (FISMA) was enacted to improve security, but its success has been marginal.

The government will use Medicare and Medicaid reimbursements to force physicians to adopt an EMR that meets government specifications. Although we do not know what those specifications will involve, they will probably be of a “one size fits none” nature. Specifications designed by committees tend to change rapidly and be unnecessarily complex. Implementing medical records is a difficult task without being forced to adopt an overly expensive and complex system.

While there is certainly a need to encourage physicians to adopt EMRs, the current strategy of implementation through legislation has many problems including patient privacy, security of medical information, and freedom of choice.

Many physicians dread making a touch decision. What electronic medical record (EMR) should they adopt, and when should they adopt it? No longer a matter of choice, the federal government instituted a deadline of 2014 for rolling out national medical records.

Selecting an EMR does not have to be a stressful process. Simplicity is the key to selecting an EMR. Simple systems are easy to install, easy to learn, and easy to use. The problem is that many physicians focus only on price. There are many important factors to considering an EMR, such as price, features, return on investment, and associated hardware costs.

Simplicity is much more important than price. It doesn’t matter whether your EMR costs $100,000 or $995, if it is complex and difficult, neither you nor your staff will use it. The money you spent and the time you invested in learning the new system will be wasted. Many physicians have heard horror stories from their colleagues regarding this very point. No one wants to be stuck with a complicated system that’s difficult to learn and impossible to use.

A simple EMR is easy to install. You should avoid complex EMRs that require a substantial hardware investment. Unless you have a large office with a lot of staff, your EMR should run on the computers you already own. A simple EMR can run on the computers you already own.

A simple EMR is easy to learn. Training time is one of the most significant costs of EMR implementation. Your vendor may charge you for training time. In addition, your practice will lose revenue because every hour spent training is one hour you are not seeing patients. A simple EMR will minimize training time.

A simple EMR is easy to use. Many EMRs have complicated screens that require you to navigate through many pages just to see one patient. Systems can also be overloaded with unnecessary features that confuse you and your staff. A simple EMR will make it easy to do your job.

Physicians can remove much of the stress out of the selection process by focusing on simple EMRs. If it takes a vendor more than about five minutes to demonstrate a system, or if a system doesn’t naturally “make sense,” then it is probably not a simple system. Remember that simple EMRs are easy to install, easy to learn, and easy to use.