Blog | Monday, October 6, 2014

EHRs: why good ideas do not always work


Any entrepreneur will tell you that not all their brilliant ideas work. Any researcher will tell you the same thing. As we develop great ideas, we cannot work through all the implications of those ideas.

One attribute of great managers involves knowing when to go to plan B. James Yorke stated, “The most successful people are those who are good at plan B.”

Unfortunately, the electronic health record (EHR) road has no apparent exits. We have no plan B. Once we enter the EHR road, we are going 100 mph with no exits, no brakes, and mounting obstacles in the road.

OK, please excuse me my attempt at hyperbole and humor. There is nothing funny about the EHR saga. My friend Bob Doherty has written a brilliant blog post on the subject, Imagine if your mechanic couldn’t fix your car before consulting an “electronic car record”

We all know that the road to hell is paved with good intentions. When Congress enacts a law, they rarely consider the unintended consequences. When new drug appears, and patients develop medication side effects, lawsuits follow. Often the medication is reviewed again, and removed from the market. My medical career has seen many great drugs fall by the wayside onto the shoulders of our highway.

EHRs are a great idea. But we should have allowed the market to convince physicians of their usefulness. Instead, we have companies developing products to impress administrators. We have EHRs focused on billing rather than patient care. We have EHRs that do not help physicians care for patients. We have EHRs that get between the physician and the patient.

Thanks to Bob for putting the problem into the proper context. I am tired of horses out of the barn or ships already sailing. Wrong is wrong. The Coca-Cola company took “new Coke” off the market and returned to the old formula. We must demand that this runaway train slow down. It really could, if we just speak loudly enough.

db is the nickname for Robert M. Centor, MD, FACP. db stands both for Dr. Bob and da boss. He is an academic general internist at the University of Alabama School of Medicine, and is the Regional Associate Dean for the Huntsville Regional Medical Campus of UASOM. He still makes inpatient rounds over 100 days each year. This post originally appeared at his blog, db's Medical Rants.