Data collection in private practice and implementation with electronic medical records

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This paper explores the area of private medical practice as a potential source for data which can be placed into, and then used by an Electronic Medical Record (EMR). The objective was to explore the potential uses of data in EMR’s and how these progress towards these advances may or may not be achieved.

Bergman explains the importance of data to the healthcare system and also the physician. Outside of academic centers, there exists a substantial amount of medical information with the potential to be used on a national level, and also on a local clinical level. For this data to be useful to a physician, it must be rapidly and easily accessed.

Private practice physicians are pressed by time and economic factors when caring for patients. These factors typically keep the thoughts of implementing a new EMR system at bay. While there are fears, time and money are not the obstacles they once were. Technology prices have fallen, and once implemented these systems can give the physician valuable information immediately at time of treatment.

The paper explains the advantages and hurdles to these EMR’s and explains various options in the applications of implementation. While encouraging the use of EMR’s, Bergman makes a solid effort to explain potential difficulties to implementation both on the private practice level, and on the national level. The private practice physician must invest time, money, and adjust to the learning curve of the new electronic systems. While many clinics use electronic systems for billing, many still do not record patient medical histories in an electronic format. This adjustment from paper to electronic version can be difficult for physicians. Use of data in a private practice has its own challenges, as does use on a national level. Combining single proprietary EMR’s with a national system can be a unique challenge as well.

Bergman concludes that while there are potential solutions provided by an EMR, there are problems faced by physicians in the day-to-day practice of medicine and simultaneously running a business. As EMR’s become more standard, their ability to share data could lead to “virtually limitless” possibilities.

Bergman MJ. Data collection in private practice and implementation with electronic medical records. Bull NYU Hosp Jt Dis. 2007;65(2):146-9.


This paper attempts to make the claim that EMR use will make data mining cost-effective in the rheumatology private practice clinics. This by in itself, is counter intuitive--yes coded electronic databases , and spreadsheet will make this much more efficient. So in my mind, this is a given.

He attempts to make his point by two means:

  1. Claiming that economical burden in the clinic will be lessened without giving actual cost savings data. Just several sentences which alludes to the economical importance.
  2. Presenting case series of patients outcomes.

The author gives examples of outcomes measures used in rheumatology of surveys and the joint exam RAPID(rheumatology assessment of patient index data) both combined will be helpful to tract patients. Unfortunately, he provided confusing figures, and basic statistics, without analysis and significance testing to make his claims.

He talks about desk top and hand health computers being helpful simply as statements, without examples or data. He talks about EMR without giving examples of any clinical information systems, vendors, nor examples of how EMR facilitates the clinic day to day affairs.

The author’s message is very simple- that EMR will be helpful. However, I do not believe this paper provided us with anything we already know. I do not think this paper was worthy of a full manuscript publication. Perhaps, an editorial or comments section.