Bad News: EHRs Don’t Work
However, now that I am experiencing the third such system of my career, I have to say that I’ve been disappointed in virtually all of these hopes. As a former programmer, I have been appalled by the frequently abysmal quality of the programming of these systems, betraying both a lack of any central design and oversight of the user interface and an absence of understanding of the typical tasks and workflow in a primary care office.
Sounds like that would be frustrating.
Hilarious that he’s supposed to summarize lab results in 100 characters – That’s shorter than this comment.
Its always a shame when systems that are designed to help end up hindering the people who use them.
Information systems are used extensively in hospitals and clinics — for billing, accounting, patient scheduling, inventory control, etc. The difference is that those systems were borne out by experimentation by software companies. The market determined which ones worked and which ones failed. Most clinics probably have Microsoft Office with Word and Excel. Gone are the days when Word Star and Visicalc (or Lotus 123) are ubiquitous. EMRs are a great idea, but they were formulated from the top down. These will become integrated into every clinic if the government doesn’t try to force the issue and let the marketplace develop products doctors and hospitals want to use.
I can understand hospital systems like those described by Devon Herrick, but the idea of a patient having an EMR accessible by every player in the health system who touches him is absurd.
Despite what people say about the use of IT in other areas, there is no similar electronic record for an individual in other areas of life. For example, Nordstrom doesn’t know what I buy at Target. Whole Foods doesn’t know what I buy at Safeway. Visa or MasterCard sort of know, but I can spoil that by paying cash.
EMRs will continue to fail as long as 3rd party payers dominate. As noted, the actual (but unpublicized) purpose of an EMR is to funnel high-cost procedures into the electronic claims system.
However, it also makes it easier for the insurer to audit claims. There are lots of software vendors on both sides of the struggle: Those that upcode providers’ claims and those that downcode insurers’ reimbursements.
Mroe than one doctor has told me he’d rather submit a paper claim, because he knows the insurer will only check two or three of the dozen or more fields, rather than an electronic claim, which can be completely scraped and audited immediately.
EMRs won’t be trusted until patients control health spending directly, at which point both they and their doctors can be confident that they will be used only for medical purposes.