Pediatricians have been among the more conservative medical specialists when it comes to electronic health record (EHR) systems: Results of a 2005 Medical Economics survey showed that only 16% of pediatricians use an EHR in the office, compared with 20% of family practitioners and 22% of internists.
However, the American Recovery and Reinvestment Act of 2009 provides $17 billion in incentives for health providers to switch to EHRs. The package also includes $2 billion for the development of EHR standards and best-practice guidelines.
Given that some if not all of the cost of migrating to an EHR system will be assumed by Uncle Sam, we can expect many pediatricians to at least consider EHR. Others will continue to wait until the finer details of the stimulus plan subsidies are released.
As a longtime user (and reviewer) of EHR systems, I believe that the government’s assumption that EHRs will help save billions in health care costs–through improving efficiency and reducing the number unnecessary medical tests ordered by physicians–is incorrect. The EHR is nothing but a new and evolving tool for documenting medical care. Like any new technology it is in the process of evolving, and when it comes to EHRs, we have a long way to go.
From a user’s perspective, EHRs help us write more legible notes, but at the cost of decreased efficiency. While reducing some medical errors due to legibility issues, they also introduce the opportunity to create a variety of new unique medical mistakes, such as documenting in the wrong record, or prescribing the wrong dose of medication. The majority of enterprise EHRs I’ve used actually decrease the staff and physician’s efficiency. In my pre-EHR days, I could easily see 30-plus patients in day. Now, while using an HER, I am lucky to see 25.
Perhaps the most frightening thing about government involvement in the EHR market is that we might all be made to use one EHR system across all specialties, with records available to medical oversight by a government “agency.” This will undoubtedly have the effect of increasing costs, since we’ll strive to further improve documentation (resulting in fewer patients being seen), and increasing the number of medical tests ordered to justify our diagnoses.
What’s your take on EHRs? Weigh in below.