Are EHRs a patient safety necessity or a barrier to care?

A doctor at a desk holding up his hand to say stop
Doctors are still divided about whether the physician community should embrace EHRs.

EHRs have emerged as a divisive issue within the physician community, with some urging widespread adoption to improve care, while others lament the administrative burden for doctors.

Both arguments were on display in a recent BMJ article that addressed whether doctors should “embrace” EHRs, underscoring the deep divide among clinicians regarding the benefits and shortcomings of computerized records.

Arguing in favor of EHRs, physician executives with Christus Health in Texas pointed to studies that showed EHRs reduced prescribing errors, shortened hospital stays and reduced mortality. Although they admitted EHR systems were still immature, and therefore flawed, the technology is poised improve.

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“The imperative to reduce this harm argues against letting the pursuit of a perfect electronic health record delay deployment of a good one,” they wrote.

Alternatively, physicians at Yale and the University of California San Francisco argued that EHRs are detrimental to the physician-patient relationship. By some accounts, physicians spend twice as much time in front of a computer compared to face time with a patient. Although technology has its place, the authors note that EHRs have yet to ingrain themselves in the traditional physician workflow.

The authors debated the pros and cons of EHRs in an accompanying podcast.

“I think that in retrospect, one of the major issues that should have been considered is a needs assessment and adjustment for the needs of the end user,” Edward Melnick, assistant professor of emergency medicine at Yale, said in the podcast.

Recently Rep. Tom Price, nominated to head the Department of Health and Human Services, said EHRs were important from an “innovative standpoint,” but Meaningful Use requirements had forced some physicians to leave the profession altogether.

“We’ve turned many physicians and other providers into data entry clerks and it detracts … from their productivity but it detracts greatly from their ability to provide quality care,” he said.

RELATED: Tom Price weighs pros, cons of electronic health records at Senate HELP Committee hearing

The reason EHRs haven’t made a splash among physicians, according to commentary by Jeanne Lenzer, associate editor at BMJ, is that EHRs were designed as a conduit for billing, rather than a clinical tool.

Surveys show that physicians are still highly dissatisfied with EHRs despite the fact that systems have been shown to reduce unnecessary care, improve care coordination and provide more customized patient care. Earlier this month, the University of Texas MD Anderson Cancer Care Center announced was cutting 1,000 employees, blaming the rollout of a new EHR system.

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