My commentary last week stating that electronic health records have turned a corner seemed to have struck a nerve--or at least more than the usual amount of interest. The article has been one of the most read and shared editorials I've written. It's also been mentioned in tweets and retweeted more than usual, especially the line "the time has come for people to stop complaining about EHRs and focus on their future."
So what should we focus on?
EHRs certainly have evolved over the years. In 2011--the beginning of the Meaningful Use program and of my tenure as editor of FierceEMR--much of the attention was on early EHR adopters, whether providers would bother to participate, how the Meaningful Use program would work and who would successfully attest. We're beyond many of those topics now.
What should also be addressed and resolved for EHRs going forward?
Here are just a few problem areas I'd like to see taken care:
- Better patient safety: There is just too much evidence that EHRs may unintentionally increase the risk of patient harm by user error, faulty design or otherwise. It's easy to compromise an EHR and harm a patient. Plus, EHRs make it much easier for crooks to access patient records and engage in medical identity theft.
- Less politics: EHRs do not need to be so partisan. Their benefits and faults are pretty universal. Why is it only the Republicans that want the Meaningful Use program paused or rebooted? At the same time, why is it only the Republicans who are asking important questions about the program, such as how the Centers for Medicare & Medicaid Services and the Office of Inspector General are ensuring that EHR users are not engaged in improper billing, and that Meaningful Use incentive payments are going only to providers who earned them?
- More vendor accountability: There are some indications that vendors are listening to providers and providing more support. But that is not sufficient. They should not be allowed to absolve themselves of responsibility by hiding behind one-sided, heavy handed unfair contract terms. Since many providers, especially smaller ones, don't have the leverage to level the playing field, there should be some alternative way to hold vendors accountable for their own actions.
- Seamless interoperability: This is an area of great promise but still in need of improvement. Inroads are being made, but until all EHRs are on the same data sharing page (and all providers adopt EHRs), there will be gaps in care coordination.
- Better treatment of our veterans: Why on earth can't the U.S. Department of Veterans Affairs and the Department of Defense play nicely together in the EHR sandbox? After years of trying (evidently not hard enough) the closest the two agencies can get to data sharing is scanning technology? Active military and veterans also have more injuries and illnesses as a whole than the general population, which is an even more compelling reason for their records to be interoperable.