Tuesday, October 22, 2013

EHRs are tools, not solutions

Yesterday, one of the residents in my program sent me an e-mail with this link:

Residents Skip Lectures to Catch up on Electronic Health Record (EHR) Charting

Here is my response to her:

EHRs by themselves can’t make offices more efficient and often have the converse effect, like we are experiencing here.  As long as EHRs are used as data repositories and nothing more, they offer little advantage over dictating (though I, having mostly grown up with EHR, am far more efficient on EHR – even a bad one like ours – than dictating).

The only way EHRs make offices work better is when offices transform their practice around FULLY FUNCTIONAL systems.

What is a fully functional EHR?  One integrated with an automatic patient history program like Instant Medical History (http://www.medicalhistory.com/home/index.asp); a patient portal allowing e-visits and easy, asynchronous dr-pt communication; and the ability to easily create and maintain patient registries.  Along with a modern office workflow that emphasizes teamwork with a family doc leading nurses, MAs, pharmacists, and physician extenders, EHRs can then make doctor’s and patient’s lives better.  Under this model, docs only see patients for about 50% of the day, leaving the rest of the day to do e-visits, connect and coordinate care with patients using the patient portal, and take care of refills and other paperwork.

But a system without those essential components, plunked into an office still operating with mid-20th century processes?  Disaster.  

EHRs are not a magic solution in and of themselves.  They are a tool to help us realize that better vision of 21st century patient-centered care.

If you can find this book online or in the library, it is worth a read – even if you just read the speech about “Dr. Olderway” and “Dr. Youngerway”:

I am excited to see your interest growing re: systems of care.  Our specialty needs people who are unafraid to challenge the status quo!

And that's all I have to say about that.