Decision Support at Marshfield Clinic

The New York Times published a glowing review today (available here) of the Marshfield Clinic's use of its Electronic Medical Record (EMR) and registry to improve chronic disease care. It also discusses the integration of the EMR into clinical research and other health functions.

You don't actually need a full-service EMR to do all the things they describe. Fletcher Allen Health Care in Burlington, Vermont has been slowly moving towards electronic systems for some time. The Primary Care providers in their eight clinics get reminders to do vaccinations, screening and other health maintenance maneuvers using a home made system that culls the information from the billing data base.

Diabetes care at Fletcher Allen is supported by the Vermedx® Diabetes Information System, which works with or without an EMR.

So, you can achieve much of what Marshfield has without such extensive infrastructure. You don't really need a full-service EMR - but it sure helps!