I was incredibly struck by a comment Tom Cox, MD made in reply to Katherine Rourke’s post about “Teaching to the EMR Template.” Here it is in case you missed it:
Of course this is happening. And, physicians in practice see it happening. But, we are powerless to change the system as many of us are held captive by our employer’s choice of EHR. EHR’s are less about health care and more about monitoring of healthcare. So, whether or not the ‘note’ is helpful to others is not important.
We’ve certainly written about EHR backlash a number of times before including my prediction of a coming Physician EHR revolt. However, Dr. Cox’s words about being powerless are quite a challenge and frankly scary.
What’s even more disheartening for me is that EHR doesn’t have to be this way. Sure, billing requirements are onerous and do put some pressures on doctors that do nothing to improve healthcare. The same could be said for meaningful use. However, there are plenty of EHR benefits to consider as well. Unfortunately, I think most of those are getting overwhelmed by some of the bad stories (and there are bad stories).
Many like to blame the news outlets for only covering the bad EHR examples. Certainly I won’t be arguing against laying some of the blame on those of us covering EHR. A disaster can often be easier to write about than an EMR success story. Plus, they’re easier to find. Not to mention readers can’t help but read it. However, I believe there’s something more happening here.
There’s plenty of blame that can be placed on the EHR vendors who do a shoddy job. We can throw some blame on doctors who don’t go through a rigorous EHR selection process or who skimp on EHR training. There’s certainly plenty of blame to go around for why EHR needs an image overhaul.
The challenge with the image of something like an EHR is that there’s no one person that holds responsibility for that image. There’s an entire industry that shapes the image of EHR. The only way to change it is for the industry to change. I only hope the fact that EHR is nearly a requirement for practicing medicine today won’t mean that bad actors will continue to scar the EHR image. My hope is renewed when I meet with EHR vendors who do have the physician and patients best interest in mind.
Maybe all of this is just the reality of the post EHR golden age environment.
