EHR struggle drives doc to quit practicing

Simply unable to make the switch from paper to an electronic health records system, a Massachusetts family physician has abandoned practicing medicine, reports.

In an April 12 letter to patients, the doctor described the EHR transition as "most difficult" and apologized for the two- to three-hour waits patients endured while he attempted to adopt the system. The doctor's prior lack of familiarity with computers in general likely exacerbated the struggle. "Not being able to type and feeling very awkward in the use of computer documentation, ordering and billing have limited my ability to effectively and in a timely manner see my patients, return calls and send out lab reports," the physician wrote.

Although not being able to type does make EHR workflows significantly more challenging, this physician's departure from his three-member group could have been prevented, says Dr. Larry Garber, medical director of informatics at Massachusetts' Fallon Clinic, which rolled out its EHR in 2009. To help some of Fallon's 300 physicians get up to speed, the clinic sent physicians to typing classes, trained some to use speech-recognition software and even provided large-screen monitors for those who had trouble reading small print. According to Garber, it's critical for practice leadership to listen to physicians describe their specific problems and then tailor solutions to their particular issues.

Nonetheless, Dr. David Kibbe, senior advisor to the American Academy of Family Physicians and co-developer of the Continuity of Care Record health data standard, says he's advised some older physicians to stick with paper until their nearby retirement. At the same time, he urges them to at least try to make a small component of their practices electronic, such as by implementing an e-prescribing system.

In addition, Kibbe predicts that EHR systems will become much simpler, cheaper and more intuitive by the time meaningful use rules are fully in effect in 2015.

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