Eric Swirsky, JD, MA
Professor Eric Swirsky discusses the current issues in the health care industry and the adoption of the electronic health record.
One of the issues that comes up for me a lot, and which I’m beginning to research, is the effect of commodification on the clinician-patient encounter. The way in which that comes up with regard to health records is that, well, in the words of some of my physician colleagues they see the electronic health record as a billing document, not as something that helps to coordinate or provide better quality care.
When one looks at the history of these systems and how they were developed and implemented over the time, one sees that the interest, very early on in the sixties and seventies, was in collecting as many charges as possible. There where physician support systems available very, very early on, but that not where the interest was for the institutional providers. It’s not the systems that they wanted. What they wanted was more efficient billing and to really increase the profitability of the business of providing health care, as opposed to using technology to promote better health. Now, with the current system where we have managed care we no longer have a fee for service we are moving towards a system.