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More than eight years and $27 billion dollars later, electronic health records (EHRs) can at best be called a moderate success.
“To improve the quality of our healthcare while lowering its cost, we will make the immediate investments necessary to ensure that within five years all of America’s medical records are computerized. This will cut waste, eliminate red tape, and reduce the need to repeat expensive medical tests.”
-President-elect Barack Obama, Jan. 8, 2009
So here we are: More than eight years and $27 billion dollars later, electronic health records (EHRs) can at best be called a moderate success.
Yes, 54% of office-based practices and nearly 87% of hospitals are using EHRs, so nearly “all” medical records are computerized in one form or another. But when it comes to cutting waste, reducing red tape and helping to avoid repeat tests … well, much like interoperability, let’s just say it’s a work in progress.
The fact is EHRs have had their successes, but those are dramatically eclipsed by the disappointment, anger and frustration experienced by the vast majority of their main users: physicians.
What doctors were promised eight years ago, with financial incentives to get on board, was an innovative new tool to improve patient care. The result, however, has been losing productivity, settling for subpar systems and creating a rift in the physician-patient relationship. The American Medical Association recently found that primary care docs spend more than half of their workday on data entry and other EHR-related tasks. That time should be spent looking at patients, not a computer screen.
As you’ll read in this issue, featuring our exclusive survey of doctors across the U.S., there’s a lot that needs to change with the EHRs currently available. And there’s frustration that when it comes to the EHR marketplace, the customer (physician) isn’t always right.
There’s a clear disconnect between what physicians want and what the marketplace provides. And when physicians decide to switch from one system to another, it is akin to what one physician described to me as “quitting the gym”: fraught with financial penalties, myriad loopholes and various other hold-ups. The result, much like trying to end a gym membership, is staying put in a less-than-ideal situation.
As part of our cover story this issue, we gave physicians a soapbox and a microphone to address EHR vendors directly, and gave the latter a chance to reply. It’s our hope that this is not a one-off opportunity. There needs to be more dialogue and collaboration between end-users and product manufacturers to actually achieve the goals President Obama describes above.
Physicians shouldn’t feel forced to use inadequate EHRs and settle for workarounds and ill-fitting templates. They should be the ones at the drawing board, bringing real-world perspective to achieve the goal of making these systems useful tools.
And while “Meaningful Use” is over and the stimulus package that seeded this program more than eight years ago is no more, the government still has a role to play in making patient data transmission a whole lot easier than it is now. In addition, it should ensure that this shortcoming doesn’t penalize physicians when it comes to collecting data for quality metrics.
It’s time EHRs live up to their promise and potential. A little more communication can go a long way towards making that happen.
Keith L. Martin is editorial director of Medical Economics. What would you like to tell EHR vendors about their products? Tell us at firstname.lastname@example.org.