By Paul Kuritzky
Charles Krauthammer has recently written two columns published on the op-ed page of The News discussing difficulties with the electronic health records (EHR) system from the perspective of a non-practicing physician and political commentator.
I offer the view of a physician who uses EHR in hospital but has chosen not to do so in my own office, despite the financial penalty from Medicare. EHR distorts and takes over interactions with the patient. Physicians, nurses and other hospital staff spend more time looking at a computer screen than at the actual patient. You can observe this on any hospital floor. In the clinic or exam room EHR distracts, and the practitioner often is typing rather than listening or making eye contact with the patient.
Often the virtual patient in the computer becomes more important and consumes more time than the real patient.
The utility of EHR is often questionable. Patient records become bloated, repetitious and filled with so much data that it becomes difficult to locate important information. Dictated narrative style notes are concise, legible and make it easy to determine the practitioner’s thoughts and pick up on important information.
Interconnectivity was purported to be an advantage of EHR. In practice this has not worked out. If you wind up in a hospital or clinic out of the area, your records from Western New York will have to be printed out and faxed or emailed. Even in Western New York the various EHR systems in use do not talk to each other.
EHR universally decreases the productivity of its users. EHR is demanding of time and energy. This was such a problem at the hospital where I see my patients, many practitioners stopped seeing their own patients due to the difficulties with and time required to use EHR. Many physicians have to spend even more time at the end of the day to complete their EHR entries for the day.
This technology has not lived up to its promise and in many ways has negatively affected patient care. Proposed medical advances are subject to rigorous trial and study with proof of efficacy required before being widely implemented. Those interventions with negative trials are discarded. If this was only so for EHR. Is there a solution? The best solution is to let the technology mature under marketplace pressure, so EHR provides a record that is easy and efficient for both entering patient data and retrieving useful information. There should be seamless sharing of EHR locally and across the country.
The EHR should enhance rather than detract from both the patient’s care and provider’s experience. It should lessen the workload on the provider rather than increase it. Until these obvious goals can be accomplished the Medicare mandate should be canceled.
Paul Kuritzky, of Amherst, is a physician practicing in Western New York.