The Trouble With EHRs

Our May/June issue of Health IT Outcomes magazine focuses on EHR technology. The healthcare industry has had a love/hate relationship with EHRs for as long as I can remember. Key government and healthcare industry leaders dating back to the Bush administration have called for the adoption of EHR systems to usher in a universal patient record. In 2009, this plan was set in motion with the EHR Meaningful Use (MU) program that was included as part of the Health Information Technology for Economic and Clinical Health (HITECH) Act. The program is intended to spur EHR adoption by offering health providers monetary incentives for not only installing EHR software, but also meeting key use criteria.

I’ll go on record as saying I’m a supporter of the MU program. I feel the healthcare industry needed a good kick in the pants to get it to move into the 21st century from an IT perspective. The problem is that the MU program became the be-all and end-all. Too many health providers are adopting EHRs simply to satisfy MU requirements and collect their incentive payments. This is a shortsighted goal. Most don’t fully evaluate how EHR technology can be applied to benefit their organizations, clinicians, and patients over the long haul. Similarly, EHR vendors became engulfed in ensuring their software was awarded MU certification, which all too often focused on attributes unrelated to usability and clinical workflow.

This is where the hate comes in. By and large, most physicians despise EHR technology because most platforms aren’t built in line with the way they work. For most clinicians, using the software is a tedious process that relies too much on them for data entry, slows them down, and interferes with their interactions with patients. EHR usability gripes came through loud and clear in the survey we conducted for our Health Provider’s EHR Wish List.

EHRs aren’t effective if you can’t get your physicians to use them. Clinician dissatisfaction is one huge reason that many providers are ripping out current EHR systems and replacing them with new ones this year. Oddly enough, another is the fact that some providers aren’t confident that their existing EHRs will be able to meet future MU requirements. A rip-and-replace initiative is a costly and involved process in its own right. Most providers can’t afford to taste EHR failure twice. Our cover feature provides a detailed look at UPMC’s formula for EHR replacement success. Hopes are that health providers going through an EHR replacement are more educated about EHR technology the second time around and can effectively apply the right technology to balance MU requirements with usability demands.