EHR Success: What is the Reality?

With the constant barrage of meaningful use success stories in the media—number of providers enrolled, dollars of incentives earned, and case studies about practices that have already received their money—it pains me to see that the experience on the ground quite often does not reflect this reality. Although they are only anecdotal, let me share two recent personal stories that I fear are representative of all too common EHR implementation failures.

I recently visited my dermatologist, whose practice purchased an EHR approximately 2 years ago (not my company’s product). When I arrived, I saw to my dismay that the office looked and operated exactly as it had before they bought the EHR—there were walls of charts; no computers in or around the exam rooms; and my physician walked in grasping my paper chart in his hand, with loosely assembled documents protruding from the edges. When I asked why they were still using paper charts, I was told that “it takes a long time to switch over to computers!” No one in the office—not the front desk staff, not the clinical staff, and not my physician—could even tell me the name of the EHR they had purchased. Clearly, little—if any—progress had been made on the implementation front in the 2 years since the purchase decision, and yet they seemed to think this lack of a transition was normal. All that money invested, and no return!

A visit to my primary care physician was equally disturbing, but from another perspective. His practice had implemented an EHR (also not my company’s product), and several of the physicians were, in fact, using the software—but not happily. He complained that he was seeing fewer patients each day, as well as staying a half hour longer to catch up on his documentation. Will he earn a meaningful use incentive? Likely yes, but at what cost?

I have always maintained that government incentives should not be the motivation for adopting an EHR. Practice improvement—cost reduction, increased productivity, and better patient care—should be the driver. With the rapidly increasing demand for care and the growing shortage of physicians, the need for easily implementable, productivity-enhancing EHR technology is indisputable, and yet so many EHR implementations are still failing. How do we as an industry address this shortcoming?