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Increased Meaningful EHR Users Aside, Grumbling Hasn’t Subsided

May 31, 2013
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Last week, the Department of Health & Human Services (HHS) put out a friendly little press release that stated something fairly grandiose. The agency declared we’re at the point where more than half of all doctors and other eligible providers have received Medicare or Medicaid incentive payments for adopting or meaningfully using electronic health records (EHR).

That is pretty big. The use of health IT, and specifically EHRs, has not just increased over the past few years, it’s pretty much sky-rocketed since the landmark regulatory legislative acts, the Affordable Care Act (ACA) and the Health Information Technology for Economic and Clinical Health (HITECH) Act. Take a look at the above link, the graphs HHS has provided, and you’ll see what I mean.

And yet, there are days when I’m talking with people, and reading various articles on the web and the comment sections below them that lead me to believe that in some doctor’s offices, the three dirtiest letters you can utter are E-H-R. I don’t think people are opposed to the idea of EHRs in general, but it seems many are opposed to what’s out there now.

What’s interesting is that I came to believe this after reading a positive New York Times piece. Yes, the same NYT that we gave grief over a few months back. This time, the Gray Lady wrote in favor of the health information industry.

In an op-ed, Thomas Friedman gave an overview of the importance data plays in helping providers get reimbursed for performance-based outcomes. His piece was then supported in separate blog posts by Todd Park, the chief technology officer of the U.S., and Kathleen Sebelius, HHS Secretary.

The upside to the ACA as well as HITECH, they all surmised, was this new marketplace for healthcare innovation using health data. A “Healthcare Silicon Valley,” is how Friedman put it.

But not everyone shares this rosy view. While reading the comments section of any popular webpage can be an exercise in fruitlessness, the NYT always seems to provoke well-thought responses from its readers. So I checked, remembering the reader vitriol about EHRs sparked by their last major health IT piece. And while there were certainly some positive responses to Friedman, the piece’s comments section was inundated with complaints on EHR usability, integration capabilities, and overall effectiveness.

Yet these complaints paled in comparison to what I saw on The Healthcare Blog recently. This piece, from a Massachusetts doctor, Hayward K. Zwerling, M.D., shows open contempt for a Massachusetts law that requires doctors within the state to be a certified Meaningful User by 2015, or they will be denied a license to practice.

Dr. Zwerling’s problem isn’t with the idea of EMRs, as he believes they could be useful in practice, but with the current product offering and the government’s mandates on what they have to use. He says these mandates are a misguided obsession from the government and place politicians in the exam room between the patients and physicians. Zwerling, the president of EMR software company, ComChart Medical Software, says, “The imposition of the EMR mandates will only delay the implementation of a truly effective solution that could reduce the cost of healthcare.”

It’s clear from having talked with leaders all across the industry—doctors, administrators, nurses, etc.—that Dr. Zwerling’s isn’t a lone voice in the woods on this issue. He is part of a large chunk of the industry that isn’t satisfied with the current product and a supposed lack of interoperability and efficient workflow, lost productivity, and government intervention.

As our editor-in-chief Mark Hagland noted in his April issue editor’s notes, there is a lot of legitimacy to those complaints.  That’s why it’s important that physicians, like Dr. Zwerling, work with the vendor community to better optimize the product.

Meanwhile, while it’s exciting that the meaningful use numbers continue to uptick, it certainly seems like we’re a long way from silencing those grumbling voices.

What do you think? Feel free to leave comments below or respond to me on Twitter by following me at @HCI_GPerna.