Death by a Thousand Clicks: Where Electronic Health Records Went Wrong

" EHR” — Electronic Health Record also, known as “Errors Happen Regularly”

“The U.S. government claimed that turning American medical charts into electronic records would make health care better, safer, and cheaper. Ten years and $36 billion later, the system is an unholy mess.”

Some troubling statistics…

~ 4000 — Approximate number of computer clicks an ER doctor makes over the course of a single shift, according to an American Journal of Emergency Medicine study

~ 5.9 hours — Average time [out of an 11.4 hour workday] doctors spend on EHRs, compared with 5.1 hours spent with patients, according to a 2017 study in the Annals of Family Medicine

~ Safety related incidents — Linked to EHR and other health IT systems have been steadily rising although, experts say cases are widely underreported. 3,789 in 2018 up from almost none in 2007

~ 3,243 — Number of medication errors linked to EHR-usability issues at three pediatric hospitals from 2012 to 2017, according to a Health Affairs study

~ $36 billion — Dollars spent on EHR implementation

How we got here…

Congress mandated and President Obama signed into law the American Recovery and Reinvestment Act in February 2009. Included was the HITECH Act (Health Information Technology for Economic and Clinical Health) which created the requirement for universal adoption of EHRs. With the stimulus provided in the act, much progress has been made as most all healthcare providers have some form of an EHR. “Today, 96% of hospitals have adopted EHRs, up from just 9% in 2008.” But that is where the good new ends. EHRs are furnished by different vendors with different structures, platforms, etc. which impact the usability and interoperability.

Physicians have taking a Call to Action…

Along with the AMA, MediStar has launched an initiative to get the message out to patients, providers, and vendors but most of all, policy makers in Washington D.C. to address the state of the dysfunctional EHR. The joint team has created a website, www.EHRseeWhatweMean.org, to actively involve the public in the solutions and take the issue directly to Congress. A request for signatures from the public and providers to sign and send the Letter to Congress drafted by MedStar Health National Center for Human Factors in Healthcare to address the issues and enable the value from EHRs.  

Saga to continue …

Article by Erika Fry and Fred Schulte published in Fortune Magazine March 18, 2019.