Physicians not skeptical of EHRs’ potential
Ever since the mandated implementation of electronic health records systems into medical practices large and small, there has been industry-wide pushback against the encroaching technology. Still, meaningful use requirements progressed to stage 2 without much fanfare, and the healthcare sector continues to march toward the Oct. 1 deadline for the transition to ICD-10 with more than a token amount of trepidation.
Throughout this process of EHR implementation, physicians have been vilified as techno-phobic and resistant to change because of their criticism of the ways that the new data collection systems are impacting their practices. However, as the predicted costs of the ICD-10 transition continue to rise, one physician is not convinced that the hemming and hawing of doctors is about their aversion to technology in the workplace – it's about the good and bad that technology is doing.
The frontline of high-tech care
David M. Denton, M.D., is the chair of the Information Services Steering Committee for the Portneuf Medical Center in Idaho and an assistant clinical professor at the University of Washington. Writing for Information Week, Denton explained that doctors get an unnecessary bad rap as ambivalent toward emerging technologies because of their skepticism of EHRs.
"Doctors complain about EHRs not because the systems are new and different, but because EHRs aren't solving their problems and may even be creating new ones," Denton wrote. "Disparate systems don't communicate, for example, or records are littered with data, obscuring pertinent information. Collaboration has not improved. Data entry has been given back to doctors, forcing them to spend hours typing. Encounters with patients have become more impersonal and more about filling in data fields than listening and understanding patients."
All of these complications have cut down on the time and attention physicians are able to give to patients, which in turn can affect quality of care. Denton explained that at the end of the day, doctors view technology from a patient-centric point of view: If a new surgical tool increases the success rate of a procedure, or a new imaging system more accurately predicts health risks, physicians will adopt it in a second. But with EHRs, that boost in the quality of care patients receive has not manifested – if anything, Denton believes, EHR implementation in its current form may be harming patient care.
Not a black and white issue
According to a study from the Journal of Risk Management and Healthcare Policy, EHRs are empirically linked to increases in treatments that follow best-practice recommendations and, as a result, produce better patient outcomes.
Denton agreed that EHRs have their place in the medical world, but their benefits to patient treatment are more theoretical than anything else at this stage of their implementation. Had they been given more time to grow with physician input fore-fronted as a major factor of development, things might be different.
"EHRs were pushed into the healthcare industry before they were mature enough to solve the problems healthcare workers face," Denton wrote. "The products were still evolving when Meaningful Use requirements forced the industry to adopt them. As a result, we have delayed their natural evolution by pushing products that perform poorly, fragment care, create vendor lock-in, and in some cases make it harder to accomplish the goals they are designed to achieve."
Denton also explained that the success rate of EHRs may be misrepresented across the industry. For large practices that can afford to employ a cadre of developers to smooth out the wrinkles in the system and cut down the time physicians must laboriously input data, EHRs have made great strides. But for smaller practices, doctors are left to fend for themselves against software that may not be suited to their needs.
