Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Why we need to suffer the growing pains of electronic health records

Richard Just, MD
Tech
August 22, 2012
45 Shares
Share
Tweet
Share

My group purchased our electronic health records system (EHR) about 5 years ago.  We had 4 clinical practice locations (soon to be 5 1/2) with 1 administration office.  None of these sites are close to each other.  A major reason for purchasing an EHR was, and still is, to collect and analyze all data from our entire practice for the purpose of determining outcomes of our treatments. In other words, we wanted to know how our patients were doing in all of our offices, which treatments were working and which were not, and then use this information to refine and practice the best medicine we could. This was the promise of EHR.

And so my nightmare began.  Some of my patients define nightmare as something you didn’t wish for and it never seems to end.  Volumes could not fully describe my experiences.  I’ll just mention one “glitch”:  I noticed that some of my notes were disappearing into the “ethernet” on a seemingly haphazard basis.  Sometimes I could locate them in another section of the chart; other times I wasn’t so fortunate.  Despite my staff spending weeks trying to find the defect, we had no success.  Our vendor monitored my work processes for two weeks.  Again, clueless.  To add insult to injury, I was told that I was the only one experiencing this problem which, of course, I took personally.  Turns out the problem occurred only when I started my note before my Medical Assistant entered vital signs.  So we had the explanation, but no fix.  As a result, I wait for my MA to enter her data, which frequently delays my ability to see patients on time.  Recently, we have added 2 physicians to our practice.  One of them asked me what he was doing incorrectly that caused some notes to disappear. This time I had the answer!! What’s more, I was now informed that it was a system wide problem for which there was still no fix.

When I was a kid, there was a TV show called the Naked City.  When episodes ended, the announcer said: “There are 8 million stories in the Naked City; this has been one of them.” I do know that my story is just one among many. But it’s still so annoying.  Because of the flawed design of this particular EHR system, we have been burdened with huge financial costs resulting from lost time, the need for extra IT support, and the hardening of my right carotid artery. I don’t need the added stress in this era of decreased reimbursements for providing clinical care and chemotherapeutic agents.  One of my partners has gone back to hiring a transcriptionist rather than using the EHR.  Another is chronically behind in his data entry.  To this date, we are not set up to pool and analyze our data for outcomes.  Soon, we are beginning the gut-wrenching process of converting to a new, and hopefully more user friendly, system.

A few weeks ago, I had the pleasure and honor to have a conversation with Eric Topol, M.D. on the “This Week in Oncology” radio show. We were both intrigued by two articles that recently appeared in the New England Journal of Medicine on this subject.  The first, entitled “Escaping the EHR Trap—The Future of Health IT“, discredits the myth propagated by EHR vendors that health IT is different from industrial and consumer IT.  The authors suggest that vendors have alleged this to be fact “in order to protect their prices and market share and block new entrants.”

The second article is also quite enlightening:  “Unraveling the IT Productivity Paradox—Lessons for Health Care.” In the 1970’s and 80’s, many industries adopted computers with the expectation that they would increase productivity.  To everyone’s surprise, digitization resulted in a significant reduction in efficiency. This was called the productivity paradox.  Subsequent research revealed that productivity attributed to computerization was underestimated due to defects in measurements, mismanagement of processes (such as summarized in the “glitch” in my system above), and poor usability.  Most systems, including mine, don’t have spell-checking capability.  Unbelievable!

In chapter 7 of his must read, “The Creative Destruction of Medicine,” Dr. Topol discusses the benefits and challenges of electronic health records and health information technology in detail.  Despite the fact that digitization initially can be associated with an increase in errors, which doesn’t ease my pain, and many other challenges, he concludes:

While some may consider the topic of electronic medical records prosaic, it should now be abundantly clear that their ultimate adoption and full interoperability will prove fundamental to the future of medicine.  Only via full electronic convergence can all the tools of digital medicine be in sync and immediately useful.  With the torrent of individualized data flow that is coming from whole genome sequencing, remote physiologic monitoring, and medical imaging, electronic information storage and processing will become more essential than even envisioned today.

I have to agree with him. While this current transition period can be a frustrating, even painful experience, the alternative of a failed health care system is unacceptable.

Richard Just is an oncologist who blogs at @JustOncology.

Prev

Doctors: Become a key opinion leader using social media

August 21, 2012 Kevin 5
…
Next

Use public health models to reduce gun violence

August 22, 2012 Kevin 3
…

Tagged as: Health IT, Oncology/Hematology, Primary Care

Post navigation

< Previous Post
Doctors: Become a key opinion leader using social media
Next Post >
Use public health models to reduce gun violence

More by Richard Just, MD

  • a desk with keyboard and ipad with the kevinmd logo

    An American oncologist looks at health in China

    Richard Just, MD
  • a desk with keyboard and ipad with the kevinmd logo

    Being insured does not equate to being covered

    Richard Just, MD
  • a desk with keyboard and ipad with the kevinmd logo

    Incorporating 12-step program concepts into cancer survivorship

    Richard Just, MD

More in Tech

  • Tackling the health care crisis with artificial intelligence: Combating physician and nursing shortages in the United States

    Harvey Castro, MD, MBA
  • The future of education: AI empowerment, YouTube college credits, and the impact on traditional colleges

    Harvey Castro, MD, MBA
  • The pros and cons of using ChatGPT for your health care needs

    Liudmila Schafer, MD
  • A new era of collaboration between AI and health care professionals

    Harvey Castro, MD, MBA
  • What I think it means to be a medical student in the wake of AI

    Jackson J. McCue
  • The rise of generative AI in health care: Here’s what you need to know

    Anil Saldanha
  • Most Popular

  • Past Week

    • The untold struggles patients face with resident doctors

      Denise Reich | Conditions
    • What is driving physicians to the edge of despair?

      Edward T. Creagan, MD | Physician
    • Beyond pizza and pens: National Doctors’ Day should be about saving lives

      James Young, MD | Physician
    • Physicians are a finite resource we need to protect

      Jack Resneck, Jr., MD | Physician
    • From clocking in to clocking out: the transition to retirement

      Debbie Moore-Black, RN | Conditions
    • How understanding cultural backgrounds can lead to better patient care [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • The fight for reproductive health: Why medication abortion matters

      Catherine Hennessey, MD | Physician
    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
    • It’s time for C-suite to contract directly with physicians for part-time work

      Aaron Morgenstein, MD & Corinne Sundar Rao, MD | Physician
    • The Titanic sinking: a metaphor for the impending collapse of medicine

      Aaron Morgenstein, MD & Corinne Sundar Rao, MD & Shreekant Vasudhev, MD | Physician
  • Recent Posts

    • How understanding cultural backgrounds can lead to better patient care [PODCAST]

      The Podcast by KevinMD | Podcast
    • From license to loneliness: the dilemma of retired physicians

      Richard Plotzker, MD | Physician
    • Tackling the health care crisis with artificial intelligence: Combating physician and nursing shortages in the United States

      Harvey Castro, MD, MBA | Tech
    • From hope to heartbreak: a story of loss in the ICU

      Ton La, Jr., MD, JD | Conditions
    • Unlearning our habits: a journey from intelligence to wisdom

      Brian Sayers, MD | Physician
    • Lessons from an orthopedic surgery journey [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 10 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • Experts Call for PBM Transparency During Senate Hearing
  • Want to Fix Medicare Pay for Primary Care Docs? How About Two Fee Schedules?
  • OTC Narcan Approval Opens New Doors in Fight Against Opioid Crisis
  • U.S. 'Flying Blind' When It Comes to Data on Substance Use in Pregnancy
  • Fear of Family Separation a Barrier to Addiction Care During Pregnancy

Meeting Coverage

  • VTE Risk in Recurrent Ovarian Cancer Increases With More Lines of Chemotherapy
  • Obesity's Impact on Uterine Cancer Risk Greater in Younger Age Groups
  • Oral Roflumilast Effective in the Treatment of Plaque Psoriasis
  • Phase III Trials 'Hit a Home Run' in Advanced Endometrial Cancer
  • Cannabis Use Common in Post-Surgery Patients on Opioid Tapering
  • Most Popular

  • Past Week

    • The untold struggles patients face with resident doctors

      Denise Reich | Conditions
    • What is driving physicians to the edge of despair?

      Edward T. Creagan, MD | Physician
    • Beyond pizza and pens: National Doctors’ Day should be about saving lives

      James Young, MD | Physician
    • Physicians are a finite resource we need to protect

      Jack Resneck, Jr., MD | Physician
    • From clocking in to clocking out: the transition to retirement

      Debbie Moore-Black, RN | Conditions
    • How understanding cultural backgrounds can lead to better patient care [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • The fight for reproductive health: Why medication abortion matters

      Catherine Hennessey, MD | Physician
    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
    • It’s time for C-suite to contract directly with physicians for part-time work

      Aaron Morgenstein, MD & Corinne Sundar Rao, MD | Physician
    • The Titanic sinking: a metaphor for the impending collapse of medicine

      Aaron Morgenstein, MD & Corinne Sundar Rao, MD & Shreekant Vasudhev, MD | Physician
  • Recent Posts

    • How understanding cultural backgrounds can lead to better patient care [PODCAST]

      The Podcast by KevinMD | Podcast
    • From license to loneliness: the dilemma of retired physicians

      Richard Plotzker, MD | Physician
    • Tackling the health care crisis with artificial intelligence: Combating physician and nursing shortages in the United States

      Harvey Castro, MD, MBA | Tech
    • From hope to heartbreak: a story of loss in the ICU

      Ton La, Jr., MD, JD | Conditions
    • Unlearning our habits: a journey from intelligence to wisdom

      Brian Sayers, MD | Physician
    • Lessons from an orthopedic surgery journey [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today iMedicalApps
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Why we need to suffer the growing pains of electronic health records
10 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...