Frustrated with your EHR? Forget about building one

Though physicians largely are unhappy with their electronic health record systems, they should quell the urge to build their own from scratch, according to a post published recently at The Health Care Blog.

Just as a doctor should recognize and hand off when a medical problem falls outside his or her area of expertise, this problem falls far outside that zone, writes Fred Trotter, a technical blogger and author.

He likens it to being able to build a car just because you work on cars and know how one should operate. Even if you are an expert at using and evaluating an EHR, that doesn't mean you can build one, he says. And the consequences of doing a poor job of it likely are far more dire.

 "You presume that because you can see the problems with EHR developer performance, that this makes you qualified to build a better EHR," he writes. "You are utterly and unequivocally wrong about this."

Trotter adds that "sometimes a feature that frustrates you is precisely what makes that EHR safe for patients. I can promise you that you cannot tell the difference between flaws and features without looking carefully at both the internals of the EHR system and all of the clinical workflows it is exercised in."

He goes on to tout open source software as a means to develop desired functions with a community of experienced health IT developers. He takes the tack that building EHRs is not a solo project, but one that requires a team of programmers and years of funding.

Among the commenters on his post, one poses the question of why a doctor would even attempt to build an EHR system if usability weren't such a problem.

EHR provider athenahealth's recently published Physician Sentiment Index found that most physicians believe that EHRs' cost outweighs their financial benefit. However, they do see EHRs benefiting patients.

And as Carol Steltenkamp, M.D., director/principal investigator of Kentucky's regional extension center, recently pointed out, often the issue with EHRs is not the technology, but the workflows that providers are used to.

Still, a recent report from Black Book Market Research predicts that more than half the EHR vendors in the market today won't be around in five years--and adds that the survivors won't necessarily be the big names. A number of small vendors are finding a niche in medical specialties where they work out many providers' frustrations.

To learn more:
- read the post