Get Ready for EHR Failures, But Don’t Blame the Software

Austin Merritt of Software Advice is a proponent of EHR and has written a column that identifies what he sees as major reasons why EHR adoption may fail:

Our concern is that the subsidies won’t change healthcare providers’ late adopter mindsets about information technology. Providers may jump at “free software” and try to avoid penalties (starting in 2015), but will they:

  • Truly believe in the value of an EHR over traditional paper charts?
  • Take a leadership role in advocating adoption of the new EHR in their practice?
  • Change their old workflows to match the best practices in leading EHRs?
  • Ride out the difficult stages of new software adoption and change management?
  • Take part in intensive training to learn the new system?

I don’t know that providers need to truly believe in something before they implement it — or even after they implement it. As a healthcare provider, there are many things I must do or need to do for a variety of reasons, regardless of whether I believe in their value. Indeed, when it comes to EMR/EHR, I think that skepticism is an appropriate attitude until we see more evidence of their actual value and and demonstrations of adequate security.

While most sources talk about reducing prescription errors, etc., what advantages do EHR actually offer to those in the field of mental health who are not dealing with prescription-writing? Electronic records pose even greater risks in terms of security than paper records. Has anyone seen any health-related breaches where the amount of exposed or potentially compromised data was larger for a paper breach than an electronic breach? I haven’t.

Austin makes five recommendations:

1. Become a project manager.
2. Rally everyone else.
3. Buy the best training you can.
4. KISS: Keep It Simple, Stupid.
5. Be prepare to practice differently.

In these tough economic times, I wonder how realistic some of this is.

Switching over to EMR/EHR, even gradually, is a huge investment of time and money. Doctors who are already squeezing in too many patients to too little time are now supposed to be project managers? Clinics that may be laying off clinical staff are going to hire IT consultants? This doesn’t sound that likely to me.

While I understand the “don’t blame the software” viewpoint, I know from experience that even when you try to investigate to find the right software for your needs, you may wind up investing time and money in a product or system that does not serve you well down the road and that instead of making your life easier and more productive, becomes the application from hell. This is not a problem specific to EHR, of course. Unless the software has backwards compatibility, health care professionals may find themselves in a real mess down the road, assuming that they can even get started.

What do others think?

Update: Jeff Drummon offers a different take/reaction on his blog.

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