Finally Talking About What Matters!

Finally, the EHR conversation has shifted to the products. Questions about the efficacy of EHRs are not new, but the stimulus legislation diverted attention from the technology to the EHR incentives. Initially, the discussion was about CCHIT certification, and then it moved on to “meaningful use.” Now, the conversation is focusing again on the EHRs—with an explosion in the number of blogs and publications discussing implementation issues, EHR experience, and concerns about existing technology.

In April, David Blumenthal, M.D., conceded in his New England Journal of Medicine article that “there are significant barriers to [even basic EHR] adoption and use: their substantial cost . . . and the technical and logistic challenges involved in installing, maintaining, and updating them.” He subsequently acknowledged, in remarks to the Agency for Healthcare Research and Quality, that “an enormous amount of research will be needed to determine the effectiveness of health information technology,” and charged President Obama’s newly appointed Chief Technology Officer with soliciting advice from providers to determine what works and what doesn’t.

Just within the last few weeks, the volume and intensity of concerns about legacy EHR technology have escalated. Here’s a small sample of what they are saying:

• Postings on the government’s blog forced the HIT Standards Committee to conclude that there is “substantial concern about the state of the EHR”; “We are not building on a firm legacy of success”; and “Physicians are not overwhelmingly satisfied with existing products.”

• MGMA’s letter to Dr. Blumenthal recognized the need for “appropriate and cost-efficient products” and encouraged “deployment of . . . alternative EHR software product[s]” in recognition of marketplace failures.

• David C. Kibbe, M.D., Senior Advisor, American Academy of Family Physicians, and Brian Klepper, healthcare analyst and consultant, suggest that “it’s become PC to ask tough question about EHRs, quality, and health care costs.”

• Senator Chuck Grassley sent a letter to each of 10 EHR vendors asking them to report complaints from customers (i.e., providers) and patients regarding difficulties encountered with HIT.

• University of Pennsylvania Professor Ross Koppel, Ph.D., believes that the federal government should have used the stimulus money to develop “more usable and more responsible software” rather than relying on outdated technology.

• A Wall Street Journal blog, entitled “Safety Guru: ‘Health IT Is Harder Than It Looks’,” relays the concerns of Robert Wachter, M.D., Professor and Chairman of the Department of Medicine, University of California, San Francisco.

• In a response to the WSJ blog, a physician argues that EHR programmers created an unnecessary level of complexity that slows physicians down and that the designers wrongly assume that physicians should “change their medical processes” to make computerization successful.

Now is the time to revisit the software. An efficient healthcare system requires efficient EHR technology. Recognizing the limitations of legacy technology is an important first step—improving the software to ensure that it is widely adoptable by all physicians should be the ultimate goal.

Related posts:

1. Research Explains Why EHRs Won’t Achieve “Meaningful Use”
2. Finally, a Voice of Reason!
3. Call to Action: Last Chance to Speak Out about EHR Standards
4. Government Has Heard Tales of EHR Woe—What Will They Do Now?
5. EHR Realities: From Your Mouth to Government Ears