Measuring EHR pain points: High cost, poor functionality outweigh benefits, ease of access

Medical Economics collected hundreds of comments from physicians about electronic health record (EHR) systems. While respondents noted the benefits EHRs provide in functions such as e-prescribing and mobile applications, they say cumbersome systems have drained cash from their practices, and worsened patient care because of inefficiencies. 

Our physician respondents filed numerous opinions about how EHRs have changed the practice of medicine, in some cases for the worse.

They say the fundamental premise of the Meaningful Use (MU) program is flawed because, like any technology, the best way to push implementation is to create a user-friendly product that helps speed efficiency.

Generally, EHRs take physician attention away from  patients, thereby reducing productivity. The systems cost too much, and they can’t talk to each other. The lack of interoperability is a major roadblock to progress, some say.

Physicians do acknowledge the positive  aspects of  EHRs, including e-prescibing, ease of access to medical data, and improved metrics of patient populations, but they only serve to highlight the promises that EHRs have yet to deliver on. 

Right now, not all, but many physicians consider EHRs more of a burden than a benefit. 

Patient visits ‘eroded’

“The acrobatics a physician has to parse through to achieve meaningful use short changes face-to-face patient interactions. With the cost of running a medical practice, (which includes rising salaries for employees, increasing cost of providing those same employees with healthcare coverage, rising cost of medical devices and consumables, and more infuriating is the slow and continual downward progression of reimbursement), patients already were complaining about wait times and shortened encounters. The encounter that was already squeezed by declining healthcare reimbursement is further diminished and eroded by a physician staring at a computer screen instead of sitting face-to-face and chatting with his patient.”  -Anish U. Shah, MD

Care declines, costs rise

“It has been my experience, in almost six years now of using EHR, that very little actually improves patient care. It has, however, added tremendously to my overhead, and more importantly, decreased the number of patients I can practically see in a day. None of this is surprising, since I think very little of EHR has been developed by clinicians for clinicians.”  -Joseph A. Anistranski, MD

Physicians shoulder burden

“Before we adopted our EHR system, when people would ask me about the subject, I’d answer that I had no real objection to the idea but ‘who would pay for it?’ So far, the answer has mostly been ‘us.’ Other than our notes being easier to read, it’s hard to see how it improves our medical care (which we feel has always been very good). I’ll feel better about it when we see resulting improvements in the ‘business’ of our practice.”  -George M. Korengold, MD

EHRs help track medical histories

“The program we use is good in that it helps us to remember what we need to be asking and examining for given complaint. It definitely helps by flagging drug allergies and interactions.” -Bruce T. Hayward, DO

Slowing us down

“Healthcare used to be about patients, nurses, and doctors. Now it’s about insurers, lawyers, and-most recently-IT people. Doctors’ records take so much longer just to read because there’s so much boilerplate garbage on them to justify coding levels. You will not stop fraud and abuse by punishing hardworking doctors. You will only drive us crazy, or into early retirement.”  -Fred Marks, MD

Too Many vendors

Because of the hundreds of the current vendors, each on different platforms, we continue to have a dysfunctional and very expensive industry that does no favors to the practicing physicians to improve care.”  -Pankaj R. Desai, MD

No time saved

“The use of computers has slowed me down considerably: My efficiency has declined, and my costs have gone up due to purchasing hardware, software, and maintenance contracts. Our system still does not communicate with other systems.” -Bruce T. Hayward, DO

Interoperability Lacking

“The government should have demanded and established interoperability of all these proprietary systems BEFORE paying physicians to convert. The result has been best described as a tower of ‘babble’. As Winston Churchill once said, ‘You can always trust Americans to do the right thing, after they’ve tried everything else.’ If only we could get past the ‘trying everything else’ stage. ”  -Susan S. Wilder, MD 

EHR Convenience

“I can see the benefit of EHRs, as I can access my patient history from anywhere. It makes it easier for me to verify facts before prescribing meds or giving advice after hours. I can provide personalized care for my patients 24 hours a day. The price I pay for that convenience is that I can never get away from it.” -Marion M. Pandiscio, MD

Unwelcome mandate

“The government has forced this down our throats. I see no improvement in healthcare, or outcomes, and [the EHR] has caused an increase in practice costs.” -Cynthia Hoffmeier, MD

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