Lisa Rosenbaum, M.D.: EHR technology must help, not hinder the doc-patient relationship

Electronic health records have disrupted the practice of medicine, but it is not yet known whether their adoption has created a temporary "transitional chaos" or "enduring harm," according to a perspective published in the New England Journal of Medicine.

The article, written by Lisa Rosenbaum, M.D., points to a myriad of problems that physicians have encountered due to the requirement to adopt EHRs, including:

  • Patient safety issues
  • The need for unusual workarounds, such as printing portions of the EHR and superimposing them in the light to look for differences in notes
  • EHR-induced stress and early physician retirement
  • The obligation to adopt technology before it was at an acceptable level of usability
  • An unclear government role
  • Overly prescriptive and ill-fitting Meaningful Use criteria

One key barrier is that physicians who point out flaws with EHRs are labeled as "technophobic" and "uncooperative," Rosenbaum says.

She points to some of the anecdotes in Robert Wachter's recent book, "The Digital Doctor: Hope, Hype and Harm at the Dawn of Medicine's Computer Age," as examples of these problems, and also questions whether pure market forces can enable the vendors to create interoperability in a similar fashion to the development of cellphones, which didn't include input from customers. 

Physicians have become increasingly frustrated with the many flaws with EHRs and the Meaningful Use program that mandates them. The American Medical Association has held two town halls to enable doctors to share their experiences and created a website so that they can inform policymakers.

To learn more:
- read the article

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