I accidentally read this post by Adam Sharp, MD over at KevinMD last Friday and immediately regretted my decision. I have heard enough about physicians’ hesitance to adopt an electronic health record (EHR) to have a pretty good idea of what I was getting myself into, but Sharp took it to another level. Stating that the main goal of government supported EHR implementation was to limit treatment options of patients and to control doctors is easily the most far fetched argument against EHR adoption I’ve heard to date (fingers crossed). Yes, there are horror stories of implementations gone awry but there are plenty of stories of how an EHR actively improves quality of care and can create revenue for a practice.
What many, many people don’t understand is that the main benefit of an electronic health record is not putting data in, but getting data out. If you are a primary care physician, can you tell me, of your 2300 person patient panel, how many females over the age of 50 have not had a mammogram in the past year? Can you tell me their addresses and phone numbers? Can you tell me their next scheduled appointment so that you can pre-order a test and discuss the results with them at said appointment? How about isolate all children under 2 without full vaccinations? What about diabetics with HgA1c scores over 9.0 in the past six months? Can you compare these performance metrics across all docs in your practice to find outliers and share best practices? Unless you have an electronic health record with a robust business intelligence platform sitting on the database, you absolutely cannot.
Furthermore, the process of implementing an EHR is a long one in which a good deal of the work is done up front before any technology starts moving (if anyone says they “installed” their EHR, they did an awful job and are going to hate it. 99% confidence interval on that statement). If you simply slap in a system without thinking about your current workflow and how the system may have to be adapted or, better yet, how your workflow is likely not optimized and how the system can help improve it, you are going to be sorely disappointed. You have get staff (physician and others) buy-in early on. You must develop a robust education plan for all users and be able to support an increased level of network traffic. This is not new word processing software we’re talking about
So yes, the initial break in period for an electronic health record is going to slow you down, but the increase in quality on the back end is well worth it. And when the government is handing you money and support to implement the health record along with quality based payments, your business justification for making the investment just improved a lot. Stop complaining. Do it. It’s not about the doctor, it’s about the patient. Let’s make this the best system in the world in which to be a patient. I’m ready to do work, are you?