Ad Supported EMRs: Bad Idea

While earning my MPH, I took a healthcare economics course with Marc Roberts, a political economist at the Harvard School of Public Health. I distinctly remember learning about the importance of advertising in a market economy. He told us to look at advertising as a means to gather more information on a particular product, something that helped us choose and then buy products that best fit our needs. He contrasted this with communist economies where consumers had limited product information and few choices. Professor Roberts’ short 50 minute lecture completely changed the way I looked at advertising, and that continues to this day.

That said, Practice Fusion’s ad supported EMR is a very bad idea. As a patient I want my doctor to choose a course of treatment based upon the best available medical knowledge. As a physician, I do not want to be influenced or confused by medical advertising that might appear in an EMR.

As EMRs evolve to incorporate clinical decision support, more and more clinical knowledge will become part of the EMR experience for the physician user. EMRs with advertising present significant challenges for physicians using them. For every patient encounter the physician needs to distinguish between medical information provided by the clinical decision support system and “medical knowledge” offered by advertising.

Although it seems fairly easy to establish rules in which the advertising is separated from the clinical decision support, enforcing such rules Is considerably more problematic. With the recent effort to reign in the perks offered to physicians by pharmaceutical companies, does it really make sense to expand advertising to physicians while they are in the process of caring for patients?

If we are to be open to inviting advertisers to pay for our EMRs, why stop there? How about bed linens? Why hasn’t some Madison Avenue entrepreneur started offering free bed sheets and pillow covers emboldened with a beautiful designer pattern and an ad for Viagra or Trojan condoms? Perhaps it is because there are limits to where advertising can and should go.

Healthcare is much too important to leave it to the influence of advertisers. If we are able to figure out how to pay for the sheets in our bedroom, we surely can figure out how to pay for EMRs that will save lives.

Other Blog Posts

New York Times - March 3, 2008
Fierce HealthIT - April 7, 2008