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Ten Years Out, Electronic Health Records Raise Ire

April 17, 2020

Electronic Health Records (EHRs) were once touted as an easily transferrable, cost-effective way to record patient care, but more than a decade after their introduction, they are a subject of heated debate.

Electronic health record requirements (EHRs) are a primary reason for medical provider burnout, and this will have a hugely negative impact on the availability and access to health care for millions of Americans, according to Citizens Council for Health Freedom (CCHF) cofounder and president Twila Brase, author of the 2018 book Big Brother in the Exam Room: The Dangerous Truth about Electronic Health Records.

Among other evidence, Brase cites a 2016 Physicians Foundation study as confirming this impact.

“Of the 17,200 physicians surveyed, 48 percent of them are making plans to leave the practice,” Brase said. “That’s a huge percentage. That means that around 50 percent of the physicians in our country are planning to leave, and they’re planning on going into nonclinical practice like research, to simply retire, or to have a small concierge practice, typically 300-600 patients.”

Spurred by Obama-Era Law

EHRs made their debut after passage of the Health Information Technology for Economic and Clinical Health Act of 2009, which created $27 billion of federal incentives for EHR adoption. Health IT.gov, the official website of the Office of the National Coordinator for Health Information Technology, EHRs would create several improvements in the health care system:

  • Provide accurate, up-to-date, and complete information about patients at the point of care.
  • Enable quick access to patient records for more coordinated, efficient care.
  • Securely share electronic information with patients and other clinicians.
  • Help providers diagnose patients more effectively, reduce medical errors, and provide safer care, improving patient and provider interaction and communication, as well as health care convenience.
  • Enable safer, more reliable prescribing.
  • Promote legible, complete documentation and accurate, streamlined coding and billing.
  • Enhance privacy and security of patient data.
  • Help providers improve productivity and work-life balance.
  • Enable providers to improve efficiency and meet business goals.
  • Reduce costs through decreased paperwork, improved safety, reduced duplication of testing, and improved health.

The promises have yet to materialize, and worse, EHRs have interfered with patient care, Brase says.

“You’ve spent 11 to 17 years to become a physician who takes care of patients, and then the majority of your time is in front of a computer, clicking boxes for the benefit of outsiders,” Brase said. “The patient is no longer your client; the patient becomes ancillary. You have become a data clerk for the health plans, the government, and others.”

Brase cites the passage of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) as creating a system that ostensibly rewards quality patient care but instead requires providers to spend inordinate amounts of computer time in order to comply with its dictates.

“I had a young physician who is going to get out of his residency and go into full practice in a year,” Brase said. “He said, 'you know, I could probably practice 100 hours a day and never burn out, if I was just doing what I love.’”

Leo Pusateri (psycmeistr@fastmail.fm) writes from St. Cloud, Minnesota.

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Leo Pusateri writes from St. Cloud, Minnesota.
psycmeistr@fastmail.fm

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