The road to hell is paved with good intentions

October 25, 2017

When the HITECH Act was passed and implemented throughout the healthcare industry, the architects of the law had good intentions.

In 2009, when the Health Information Technology for Economic and Clinical Health (HITECH) Act was passed and implemented throughout the healthcare industry, I truly believed the architects of the law had good intentions.

The creation of data systems storing patient information and communicating with one another would ensure immediate access to a patient’s records no matter where that record was stored. This would help reduce duplication of testing or prescribing, cutting waste while also providing improved care.

The policymakers envisioned systems that would be user-friendly with easy data entry. The systems would be cost-effective and interoperable, feeding health information exchanges where data could be mined for improved population health management.

The expectations for higher productivity among physicians and other providers drove the financial incentives to purchase systems and integrate them into practice workflow. Technology vendors would work with physician users to improve the systems. As I said, it was a noble vision with good intentions. 

Eight years later, we now know that this noble vision is a nightmare for the vast majority of physicians. Systems are not interoperable. Data entry is clunky and a distraction from patients. I’ve seen the cost of these systems drive many independent physicians out of solo practice and now we are being punished with lower reimbursement and penalties if we are noncompliant with system use.  

I believe that a good system can help manage a practice and patients more effectively, however, the pain associated with implementation can be very discouraging. Broken promises regarding electronic health record (EHR) functionality, poor customer service and hidden fees all contribute to added stress on physicians. 

 

Wake up, Washington, D.C. It is time for action and a solution. This is not about physicians whining and complaining about using EHR systems, but rather recognizing the inherent flaws created with the implementation of HITECH and fixing them.

The cost of implementing new guidelines for usability and interoperability should not be borne by physicians alone. Initially, the government doled out billions in incentives to physicians for installing systems and using them to create a standard. While at the time these incentives seemed generous, we now know that they barely covered the cost of implementing an EHR system. 

If the healthcare industry as a whole is benefitting from the use of EHRs, then the industry should bear the burden of the expense to fix the problems. Create a superfund to finance the development of a solution. Give physicians a voice in developing usability standards. Don’t ignore the problem.

The vision of the original architects was a good one. Since 2009, technology has advanced even faster, especially mobile technology and apps. If this country can get a fresh food order to a person’s doorstep within hours, we should be able to figure out how to create user-friendly, cost-effective and interoperable EHRs that deliver on the promise of improved patient care. 

 

George G. Ellis, Jr., MD, is chief medical adviser for Medical Economics. How would you make EHRs meet the goals they were originally intended for? Tell us at medec@ubm.com.