A State of Transition for EHRs

This past month I chaired a symposium at the American Academy of Dermatology Annual Meeting in Miami, during which several of my colleagues discussed the challenges and benefits of implementing EHRs and the effect it’s had on their practices. I have been fortunate to chair these sessions for the past few years and am pleased to note that with each passing year the attendance seems to increase and overall interest in EHRs is raised. While it is encouraging in some respects, frustrations remain widespread over meeting the current qualifications for the federal government’s Meaningful Use incentive program (which I have documented in this column over the last several years). In addition to these, many folks are searching for real-world advice and strategies for implementation and using the technology to benefit practice.

Many EHR users and prospective users are asking themselves, “So now what?” If an answer presented itself, we wouldn’t be asking the question. Nevertheless, the question is relevant because it presents an accurate reflection of our current state. It remains impossible to tell whether this grand experiment will result in the overall benefit of our patients and improvement in our healthcare system. Importantly, EHRs are not merely records. They are a means of re-appropriating everything that we do as clinicians; that affects how we interact with patients and how we manage our businesses. Perhaps that is why I continue to see consistent frustration about the state of affairs regarding EHRs. The fact is that this process is going to be slow, and until the market evolves we will not have a clear vision of EHRs in either our specialty or in the healthcare system at large.

Given these circumstances, it is appropriate for this column to address the utility of EHRs as well as charting the latest developments in the larger scope of EHR technology in a more head-on way. Over the next several months, physicians who presented at the AAD symposium will be divulging their own insights into the state of EHR by sharing their experiences with their particular system. The best way to gain a sense of how an EHR works for you is to see it in use in a practice setting. Contributors will take on a range of issues related to their specific EHR and broader landscape of the technology in our specialty. They’ll discuss everything from usability to practical considerations of this technology.

From there on, the emphasis of this column will shift to take on the use of these products and technologies beyond the exam room, touching on topics such as clinical decision support as well as data collection. Ultimately, these are the issues that physicians are going to devote more thought and time to going forward. Whatever frustrations we may feel with the implementation of new technology and how it’s changing what we do, the most important thing now is that we continue to adapt to the changing conditions of technology and begin to conceptualize how we can all benefit from it in the future.

Mark Kaufmann, MD is co-chair of the Dermatology workgroup for CCHIT. He is on the Medical Advisory Board of Modernizing Medicine.