Doctors Are Talking: EHRs Destroy the Patient Encounter

Neil Chesanow

Disclosures

May 22, 2014

In This Article

EHR Rankings Hint at Physician Revolt

KLAS, a national firm that measures EHR vendor performance, conducts an annual poll of healthcare providers, not only about the quality of their EHRs but also about make-or-break issues such as training, implementation, and support.

In this year's ranking, an EHR that doesn't depend on a lot of mouse-clicking won top honors. Were physicians who use EHRs delighted by this news? Far from it. For most commenters, the article served as a springboard for expressing their disdain for EHRs. "Dumbstruck," "upset," "junk," "garbage," "phony," "depressed," "disheartened," and "a nightmare" were just a sampling of the negative terms used.

"The whole point of electronic medical records is to allow the payers (insurance companies, not patients) to monitor, critique, and penalize us for our work," a doctor contended. "It is not and has never been for the benefit of patients or to improve patient care."

"I've been doing this for almost 20 years," a pediatrician wrote. "In all that time, I've never seen more than a small handful of children who would have, in any way, truly benefited from my having an EHR system."

"The EHR is designed by nonphysicians and pushed on us," another doctor insisted. "The problem is that nobody has the fortitude to just defy expectations. We all just sit dumbstruck and upset. Nothing changes."

"You should see the 5-page garbage I get from other MDs' EHRs when I request patient records," a doctor fumed. "They are nothing but electronic copy-and-paste junk and add nothing to patient care."

A hospital administrator had the temerity to suggest that doctors had brought their EHR woes on themselves. "Remember, this is in response to the lack of legible, accurate, timely information you 'doctors' have failed at for many, many years," she observed. That remark brought a rain of hail from physicians.

"You can stick it where the sun don't shine," a urologist suggested. "The entire purpose of the medical record is not for the lawyers, insurance companies, or you hospital suits, but rather to serve as a means of recollection of a patient encounter for the treating physician. The government, legal profession, health insurance industry, and two-faced, phony hospital administrators have reduced a once-noble profession to a group of depressed, disheartened, frustrated, overworked, overburdened, and underused data input clerks."

One physician cited a popular cloud-based system as an example of an EHR done right. "It is quite user-friendly, being infinitely modifiable on the fly, without one having to be a software engineer to accomplish what you need," he said, adding, "Their support is second to none, with very rapid turnaround time."

To which another doctor, who used the same EHR, had this to say: "Our large practice found it to be a nightmare! Two-thousand clicks, cumbersome, non-intuitive, time-consuming, and very difficult to use. Would not recommend it."

But despite the negative comments, one doctor, miraculously, managed to end his thought on a cheerful note: "The system I use is better," he wrote. "I've increased productivity. I'm making more money. I even have time," he added slyly, "to comment on articles like this."

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