My Thoughts on the New York Times Article

My Thoughts on the New York Times ArticleI woke up Tuesday morning excited to see a lead story about EHRs in the New York Times. I had expected to read about the impact that meaningful use is having on the EHR industry and the practice of medicine, because that was the subject of the 45-minute interview I had with the author 3 weeks ago. Instead, I was rather surprised to see the article’s title: “A Digital Shift on Health Data Swells Profits in an Industry.

The article focused on the politics behind the funding of the EHR Incentives Program— aka “meaningful use”—which is a very important story but one that was already covered in 2009 in a Washington Post expose titled “The Machinery Behind Health-Care Reform: How an Industry Lobby Scored a Swift, Unexpected Victory by Channeling Billions to Electronic Records.” (For more information, see my EMR Straight Talk post on that article.)

The New York Times article went on to castigate EHRs with the following statement, backed up by a quote from a physician:

. . .these systems also have many critics, who contend that they can be difficult to use, cannot share patient information with other systems and are sometimes adding hours to the time physicians spend documenting patient care.

“On a really good day, you might be able to call the system mediocre, but most of the time, it’s lousy.”

The online version of the article had 495 highly charged negative comments, which are worth perusing to understand the current sentiment among physicians.

I have not been shy about expressing my concerns about the effect of the typical point-and-click EHR on physician productivity, and about the sapping of innovation brought about by the complexities of the meaningful use regulations. However, I do see a silver lining in the meaningful use cloud, and that is the establishment of standards that are already having profound and positive effects on interoperability. In my interview with the author, we talked at length about the problems of EHR-siloed information and the benefits that certification will bring to the sharing of clinical data among providers, HIEs, and patients. Painful and costly as the certification process has been for EHR vendors, this standardization is advancing the industry and addressing many of the concerns expressed in the comments.

I hope that the New York Times will consider future stories about the progress being made towards EHR interoperability and about the differences among EHRs that distinguish the physicians who are reaping the benefits of their EHRs from those who are suffering from the negative impact of theirs.

3 Responses to “My Thoughts on the New York Times Article”

  1. Until the clerical burdens and clinical risks posed by today’s clinical IT, often presenting a mission hostile user experience, is remedied, interoperability is not particularly relevant to improving acceptance.

    By way of analogy, aking devices interoperable that give users an electric shock every time they try to use them is not a valid path to success. Improving the device’s electrical properties must come first.

    Until the fundamentals are rigorously addressed, opposition (and bitterness, openly expressed in the reader comments at the NYT) will grow.

  2. Opposition and resentment towards EMR companies can be overcome by having interested and motivated physician champions as consultants who can provide specialty specific guidance. A small practice physician with some software knowledge and who encounters daily EMR challenges should be considered an asset who can promote and market the benefits of the EMR using minimal effort, support and financial investment. Catering only to the next big customer will not achieve the desired interoperatability. If the needs of the stakeholders are met, the EMR will be successful.

  3. As an Orthopedic scheduler, I like, to a degree, our EPIC system. However it is not fully implemented to allow us full use of all the bells and whistles yet. I understand what the providers are saying when they ask why their input was not asked for prior to jumping into this EMR era. I believe what has always been missing in any software or IT development is –asking the end users what would work or what they need to do their job. I go back to manual typewriter days, so I have seen a LOT of change. If the systems currently in use do not “talk” to each other I don’t understand how spending millions of dollars on implementation is going to cut costs or make health care delivery better.

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