Friday, February 12, 2016

Electronic Health Records Marriage Vows May End in Divorce
I’ve been thinking  of electronic health records  and their mating with physicians  compared to  the Catholic marriage vows,  which  I have taken and which, as you know,  go like this, “” to have and to hold, from his day forward, for better, for worse, for richer, or poorer, in sickness and health, until death does us part.”
The U.S. health system has imposed a  similar marriage vow  between physicians and the Internet.   The vow aims to improve the system in sickness and health, until  death does  the physicians and the Internet  part. 
This is inevitable,  as Alfred Chandler, Jr. (1918-2007),  Professor of History at Harvard Business School and Johns Hopkins University,  observed,  “All I know is that the Internet will transform the world.”   And indeed it has.  
But as a latter day historian of the Internet,   Silicon Valley-based   Andrew Keen, expresses in his 2015 book  The Internet Is Not the Answer (Atlantic Monthly, 2713, 2015),  the Internet may not be the key to a successful digital marriage.    A reviewer of the book says “It  is a packed compendium of the ways digital life casts aside basic human virtues in favor of a rapacious winner-take-all economy.” (Michael Harris,  “Book Review, Washington Post, January 2, 2015).

The physician-computer marriage, like most marriages, may end in divorce.    This is what  is occurring with the marriage of electronic health records with physicians.  The two are proving to be incompatible.   EHRs,  physicians in the main agree,  distract from patient care,    are clinically dysfunctional ,   create  unnecessary overhead expense , and do not improve quality of care.   EMRs, to use Health Information Technology lingo, are not  “meaningful”,   which is why, in the face of massive physician protests, that CMS has abandoned its “Meaningful” EHR stage 2 and 3 programs.
In the Medinnovation and health reform blog, I have written over 50 blog posts questioning the value of EHRs.    Here are 7 of them, which you may read by going to Medinnovation and Health blog post,  and typing in the title in the search box.

·         “Limits of Technology – A Data-Doubting, Technologically -Incorrect Tale”,  September 17. 2007
·         “Mandatory Electronic  Health Records – The Right Thing to Do?”,  November 15, 2007

·         “Electronic Medical Records – The EMR Funk,” March 31, 2008

·         “Data Use and Misuse – Contrawise, Confessions of a Data Contrarian,” August 6. 2008

·         “Unnatural Human Communication – The Main Barrier to Electronic Medical Records,"
April 27. 2010

·         “Meaningful Use – Clinically Useful or Bureaucratic Boilerplate, “ July 24. 2010

·         “The EMR Absurdity,” December 29, 2015

Sometimes, even in the face of most noble and well-intentioned of vows, divorces ensue  after a trial run, in this case a 7 year marriage initiated by a $30 billion 2009 Health Information Technology  Stimulus designed to improve health care and advance reform.

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