As EHRs and related health IT products became more commonplace in the past decade, physicians interested in going digital saw a chance to get free of paper files while increasing efficiency and productivity. Then along came CMS' Meaningful Use program in 2010, which required physicians to adopt certified EHRs — which would contain specific qualities outlined by the government — and imposed financial penalties on those who didn't make the jump, whether they were ready or not. If physician dissatisfaction is any indicator, this rush to adapt to health IT has brought more problems than it has solved.
Physicians are frustrated with hassles and challenges their EHRs have created, from data input taking time away from face-to-face patient care, to an inability to customize software to their practice's needs. A 2016 report from Medical Economics found that 37 percent of physicians surveyed reported that their EHR "detracted from the care they provide to some extent." In this year's Physicians Practice Technology Survey, 67.9 percent of respondents said their practice did not see a return on investment from their EHR. Moreover, as experts note, disparate health IT systems often silo data, making sharing between practitioners difficult and creating work flow frustrations.
Perhaps the most damning statement on health IT came from former CMS administrator Andy Slavitt in February2017 at the annual Health Information Management and Systems Society (HIMSS) conference, when he called health IT a "failed industry."
Slavitt isn't the only one that feels this way. Nearly three-fourths of respondents to the Physicians Practice Tech Survey agreed with the former CMS chief that the health IT industry is failing because doctors don't like the technology they use.
Slavitt and other health IT experts spoke to Physicians Practice on why doctors hate their EHRs and concerns that health IT may not overcome its biggest failures any time soon.
Who's to Blame?
Slavitt's opinion of health IT has not changed since February, and he says that "almost everybody gets a piece of the blame," though he lets physicians off the hook, when it comes to the abundance of inadequate health IT products. He points primarily to the government for "over-engineering regulations," and the EHR vendors "for not building software that is user driven and solves problems," and for designing products with limited interoperability, which "have made the industry much more siloed," he says.
Slavitt says vendors need to take a step back to reevaluate whether their products are achieving the goals that physicians need them to, and suggests they take inspiration from almost any other industry. "All we have to do is make a travel reservation to see there is tons of intelligence at work that helps us find the right flight in a user friendly way. We don't get that in healthcare," he says.
Indeed, Jose Almeida, MD, a vascular surgeon and director of the Miami Vein Center, has experienced the hollow reality of the technology that hasn't lived up to the hype. "The idea of an EHR was utopian in a sense, everything digitized, all the data structured and reformattable for different purposes [and able to move across different provider settings]." Instead, his practice is now on its fourth EHR in eight years.