Friday, February 28, 2014

"EHRs: The Real Story" - Sobering assessment from Medical Economics

From Medical Economics -

"EHRs: The Real Story",  pg. 18-27, Feb. 10, 2014, available here (PDF).

Full issue at http://medicaleconomics.modernmedicine.com/sites/default/files/images/MedicalEconomics/DigitalEdition/Medical-Economics-February-10-2014.pdf - it is large, 12 MB:

... "Despite the government’s bribe of nearly $27 billion to digitize patient records, nearly 70% of physicians say electronic health record (EHR) systems have not been worth it. It’s a sobering statistic backed by newly released data from marketing and research f rm MPI Group and Medical Economics that suggest nearly two-thirds of doctors would not purchase their current EHR system again because of poor functionality and high costs."

Here are other key findings from this national survey:

  • 73% of the largest practices would not purchase their current EHR system. The data show that 66% of internal medicine specialists would not purchase their current system. About 60% of respondents in family medicine would also make another EHR choice.
  • 67% of physicians dislike the functionality of their EHR systems.
  • Nearly half of physicians believe the cost of these systems is too high.
  • 45% of respondents say patient care is worse since implementing an EHR. Nearly 23% of internists say patient care is significantly worse.
  • 65% of respondents say their EHR systems result in financial losses for the practice. About 43% of internists and other specialists/subspecialists outside of primary care characterized the losses as signifcant.
  • About 69% of respondents said that coordination of care with hospitals has not improved.
  • Nearly 38% of respondents doubt their system will be viable in five years.
  • 74% of respondents believe their vendors will be in business over the next 5 years.

My own views are:

While some might dismiss such surveys as well as reports of harms as "anecdotes" (those same persons conflating scientific discovery with risk management, see http://hcrenewal.blogspot.com/2011/08/from-senior-clinician-down-under.html), I observe that such articles/surveys are increasing in frequency the past few years and are coming from reasonably capable observers - clinicians - .unlike, say, a Fox News survey of pedestrians on complex political matters.

Another physician survey is here:  http://hcrenewal.blogspot.com/2010/01/honest-physician-survey-on-ehrs.html.

Here's an interesting ad hoc survey of nurses:  http://hcrenewal.blogspot.com/2013/07/candid-nurse-opinions-on-ehrs-at.html.
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This is not what the Medical Informatics pioneers intended, and is not due to physicians being Luddites (a topic I addressed at http://hcrenewal.blogspot.com/2012/03/doctors-and-ehrs-reframing-modernists-v.html).

In my opinion, organizations that have the expertise to change the current trajectory of this technology such as the American Medical Informatics Association (AMIA) needs to leave its tweed-jacket academic comfort zone and become more proactive - or perhaps I should say aggressive - in combating the industry status quo.  

The health IT industry trade associations such as HIMSS have no such qualms about aggressively and shamelessly pushing their version of EHR utopia, an agenda that has led to massive profits for the industry... but to clinician survey results such as above.  And to injured and dead patients.

-- SS

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