Electronic records and economic sense

Stanley Feld has been doing a series on why physicians are slow to adopt electronic records.

The common perception is that they are expensive or ludditic doctors are desperate to cling to paper charts.

The main problem is that the current crop of EHRs are simply not ready for prime time. I recently read a story where doctors have their staff print out a patient’s electronic record for every encounter, then handwrite a note and have the staff scan it back into the computer.

Furthermore, the EHR learning curve ranges from a few weeks to a months, depending on how computer literate you are. When revenue is based on number of patients seen, the loss of productivity, compounded with the cost of the EHR, is financially crippling.

What a deal.

If widespread electronic record adoption is to occur, the following needs to happen:

i) EHRs need to make the doctor’s life measurably easier, and accomplish what the physician currently does in less time

ii) the cost and loss of productivity during the startup period needs to be reimbursed 100%

Until those conditions are met, the dream of universal electronic records will never be realized.

Update:
Someone e-mailed asking me for my solution. Here’s it is.

Implement open-source VistA in every physician practice in the country, free of charge. This will also solve the compatibility problems caused by hundreds of EHRs permeating the market that don’t talk to each other.

Give a stipend to each practice, equal to one month’s average office revenue, to compensate for productivity loss during the transition.

Voila, problem solved.

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