How to convince doctors to embrace electronic medical records


Doctors are now incentivized to convert antiquated paper charts to electronic medical records.

Despite a few doctors who love their EMR, most readers here at are skeptical, as the difficulties in transitioning, along with questionable benefits, have been well chronicled.

Recently, the Washington Post reported how the current incentives aren’t necessarily leading to a stampede towards electronic medical records.

Among the worries is that, “many doctors point out that they bear the biggest costs, while patients and insurance companies benefit most.” Indeed, when I wrote about the issue in USA Today a few years ago, “doctors receive only 11% of the savings from electronic records, with most of the savings going to health insurance companies and the government.”

Pediatrician Aaron Carroll notes some of the barriers the current health IT industry present to doctors:

Such systems are hard to use and difficult to maintain. They disrupt clinical practice. They don’t increase efficiency and often don’t pay for themselves. They disrupt the doctor-patient interaction. And they are very, very expensive …

… But it needs to be done. I fear that the current incentives – simple monetary carrots and sticks – that the government is trying in order to increase the use of information technology in the practice of medicine won’t work. Just as we have a patchwork insurance system in the US, we have a patchwork IT system as well. There are relatively few standards, tons of companies, and lots of failures. It costs too much, it doesn’t work as well as you’d think, and there are way too many avoidable errors.

Fragmentation is a problem.  Doctors don’t know who to trust, and many fail expensive IT conversions as they realize that demos by slick salespeople often don’t replicate real-life clinical practice.

Overseas, the NHS has taken the opposite approach, by implementing an electronic system from the top-down.  There have been growing pains there as well.  But, in the end, the result would be a unified, universal health IT system akin to that of the VA Stateside.  Perhaps there’s value in that approach.

The bottom line is that converting to electronic medical records is difficult, no matter how it’s done.  Most health IT experts have little clinical expertise, and forcing doctors to use systems built by computer engineers is a recipe for disaster.

The only way to get more doctors to use an electronic record system is to include physician input — from actively practicing providers — every single step of the way.

 is an internal medicine physician and on the Board of Contributors at USA Today.  He is founder and editor of, also on FacebookTwitterGoogle+, and LinkedIn.


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