The Downside of EMRs

US health care reformers who believe that forcing hospitalsElectronic Medical Records and physicians to participate in centralized electronic information systems for patient records, test results, and physician order entry should be concerned about what is happening in Britain. Three major London hospitals had their information systems shut down by the Mytob worm on November 18, 2008. The incident shows the downside of electronic medical records (EMRs): patient care can be put at risk and costs can increase.

The affected hospitals activated emergency paper and pen backup systems. Ambulances were diverted to other hospitals. Electronic patient records were not accessible. And the incident reportedly caused delays in care and treatment. Another worry is that the worm could put confidential data at risk by allowing hackers to control the network and receive information from it. [link]

Cleanup of roughly 5,000 potentially infected PCs had almost finished by December 1. [link] The National Health Service's faltering national IT program was intended to replace fragmented networks and systems with a centralized network. Yet fragmented systems, if infected, typically cause only isolated or localized disruption. The centralization likely allowed the infection to spread to other hospitals as patient records were shared. [link]

Mytob first appeared in March 2005. It is unclear how the hospital systems were infected, since standard anti-virus software blocks it. The investigation is continuing. [link]

Poor system security may be endemic to government enterprises in general and U.S. government enterprises in particular. According to the Washington Post, evaluations of federal agency compliance with the Federal Information Security Management Act suggest that its documentation requirements encourage agencies to spend money on paperwork exercises that do little to fix identified problems. Agencies that earned failing grades in 2006 included the departments of Homeland Security, Defense, Energy, State, Veterans Affairs, and Health and Human Services. [link]

Comments (5)

Trackback URL | Comments RSS Feed

  1. Joe S. says:

    Another terrific piece, Linda. You are an invaluable asset to this site.

  2. Larry C. says:


    This should be required reading at HHS.

  3. Nancy says:

    It seem to me that in every other profession, people on the supply side of the market use computers and software whenever it makes sense.

    What’s holding medicine back is not the doctor. It’s the bizarre system of third-party payment. I think the NCPA has shown that computers are quite common in those health care markets where the third-party payers are not.

  4. […] the face of so much cheerleading, we have previously cautioned here, here and here. This is a doctor writing in the New York Times: In short, the computer […]

  5. […] previously reported here, here, here and here. EMRs work best when they are essential to the services doctors offer. That […]