Doctors urged to hang on for more useful EHRs


“Don’t give up hope,” writes a doctor in the new issue of the Journal of the American Medical Association.

That rather dramatic plea comes in the context of a piece in which James J. Cimino, MD, argues that the promise of EHRs will be fulfilled, but it might take another technological generation or two.  Moreover, his pitch comes at a time when surveys show physician dissatisfaction mounting as EHRs spread across the healthcare sector.

The full article is behind the JAMA firewall, but with a number of excerpts this summary gives a pretty good look at the doctor’s argument.

"Improvements in the documentation process hold promise for more than simply efficient data entry and legible notes," Cimino argues, going on to note, "If impressions and plans can be captured within EHRs as explicit data elements, using standard terminology rather than being buried in the narrative text of a note, clinicians could use this information to better support clinical workflow."

Pointing to the genesis of EHRs as offshoots of electronic billing systems, Cimino says "EHRs had to start someplace, [but] rather than complain about the challenges they have introduced, clinicians should recognize that current EHRs are illuminating the opportunities for the next generation of systems that will support clinicians as active partners across the spectrum of healthcare settings and tasks."

The problem is, an increasing number of doctors, it seems, aren’t really thinking of those future possibilities.

In a presentation at HIMSS13, William S. Underwood, senior associate at the American College of Physicians, unveiled a multi-year survey that found, among other things, that “there's been a 12 percent increase in dissatisfaction with features and functionality of EHRs between 2010 and 2012. There's been a 14 percent increase in dissatisfaction with ease of use. There's been an 11 percent increase in dissatisfaction with customer support.”

Moreover, “Thirty-nine percent of those polled would not recommend their EHR to a colleague. Thirty-eight percent would not purchase the same EHR again.”

Underwood and his co-presenter, Alan Brookstone, MD, chief executive officer of Vancouver, B.C.-based Cientis Technologies, noted that satisfaction levels seem to rise the longer new systems are in place, but simply counseling patience, as Cimino does, overlooks the fact that providers are dropping serious money into the health IT transition.

And while it’s not a stretch to assume that the technology will continue to evolve and become more productive, that assurance of a “better” future may not be much consolation to providers who are wondering when, if ever, they’re going to see a return on their substantial investment.