Over my years in business, I’ve received the usual pieces of advice. One is “Be careful what you ask for; you just might get it.” Another is “Never ask a question to which you don’t already know the answer.” Luckily, no one gave that advice to the government before it launched the Federal Advisory Committee (FACA) Blog last week. The result is that the government is getting plenty of the direct, honest feedback that they asked for, but the answers are not what they expected. And that’s a good thing.
The decision-makers are hearing the voice of the physician and they fear that many will opt out of participation. Consequently, the HIT Standards Committee is soliciting “real-world” EHR implementation stories—they held a public hearing and launched the FACA blog/website. I suspect that they anticipated hearing successful EHR stories and practical suggestions about how to facilitate widespread adoption. Instead, they got an onslaught of disparaging comments that document failed implementations and the perils of productivity-sapping traditional EHRs.
The following comments are representative of the feedback the blog is eliciting:
“The primary benefit to our organization has been the ability to exchange patient information among our 6 offices, as well as general communication within the organization. The negative has been a drop in physician productivity of 20-30%, commensurate with published studies. This has occurred in spite of extensive use of templates and speech recognition and is unlikely to improve in the near future. Furthermore, there is no evidence that there has been any improvement in patient care.”
- F. Ray Nickel, M.D., 12-physician orthopaedic group that implemented a traditional EMR in 2007
“I have had the “opportunity” to use three different EHR systems (all from implementation) at my last job. All of them had huge gaps, especially as a specialist. I found that I needed an extra 5 hours per week to finish documentation. And on top of that, my productivity permanently dropped. There were some benefits, but all on the retrieval side. On the data acquisition side, things were slowed dramatically. Also, patients were unhappy that I was spending more time on the computer than looking at them.”
- Theodore Curtis, M.D., ophthalmologist
“I’m all for using EMRs meaningfully, and second, I’m all for rewarding physicians! However, I believe (as many do) that our current crop of EMRs are far from perfect and I have to question whether we could spend that $36 billion a better way than by rewarding mediocre vendors whose products are poorly adopted and poorly used (see the National Research Council’s recent report: http://books.nap.edu/openbook.php?record_id=12572&page=R1).”
- Lyle Berkowitz, M.D.
“Does making the physician the data entry worker (the slowest and lowest paying job in an office) make sense when by 2025, there will be 200,000+ shortage of health care providers?”
- Jeff Moody, M.D.
“I do orthopedics in a large, multi-specialty group. We have been on Excellian (a version of Epic) for three years. It adds 45-60 minutes per half day of clinic patients. As a specialist, I found little good for me in this system, but many frustrations and slow-downs. For my patients, the EMR is marginal (may help or hinder them), but for me the electronic record system is inefficient and hateful!”
- Scott Lagaard
There is still time to post a comment* documenting your experience and/or suggestions. The blog will accept EHR implementation comments through mid-November, when they will be summarized for presentation at the November 19 Standards Committee meeting.
Although this may not have been the input the committee was expecting, I hope they will value the insights offered and use them to truly facilitate widespread EHR adoption.
*To post a comment, click here, scroll down to “Post a comment,” and type in the CAPTCHA Code (the phrase in the box at the bottom.)
Related posts:
- Call to Action: Last Chance to Speak Out about EHR Standards
- Government Has Heard Tales of EHR Woe—What Will They Do Now?
- EMR Certification: Government Warns “No Guarantee of Incentives”
- Government EHR: Teetering on the Backs of Physicians
- Government EHR Program: Potentially Harmful Unintended Consequences
