EHRs are rapidly becoming the Rodney Dangerfield of eHealth (‘I don’t get no respect’). No surprise to any doctor or clinical staff who uses them–but the realization has dawned that it has actually made charts more labor intensive. “I think we’ve sort of made the paper chart electronic, but what we’ve done almost nothing of is automation.” has to be one of the drollest quotes of the past few years (Dr. Donald Rucker, VP and chief medical officer of Siemens Healthcare USA). Instead of using computers to automate, EHRs make records even ‘stickier’. Hospitals like it because it helps capture billing more accurately. MDs aren’t technophobes (a common accusation) but “they’re not going to embrace any technology that makes them less efficient”. Neil Versel takes a ‘gimlety’ look at the subject in his comments on this TEDMED webcast (1 hour recast here) in InformationWeek Healthcare.
And the think tank RAND Corporation adds to the pile-on, with RAND rethinking its optimistic 2005 analysis of $81 million in HIT savings that fed the proliferation of EHR companies and Federal subsidies. Expected savings haven’t materialized, and productivity, interoperability plus quality benefits haven’t been achieved by existing systems, according to Dr. Arthur L. Kellermann, one of the authors of the analysis published in this month’s Health Affairs (abstract only). A list of shortcomings as long as the East River are discussed far more critically in commentary featured in the NY Times, Charles Webster, MD’s EHR blog on how you get to the ‘iron triangle’ of unstable software (hat tip to Vince Kuraitis), and Brian Ahier’s commentary on (this is a first) Google+.