Current EHR environment dooms chances for a better healthcare system

Regarding the Oct. 15 cover story on electronic health records (“No end in sight,” p. 6), how many examples do we have to see before we realize this emperor has no clothes? The EHR is a great thinktank and administrative idea, but the complexities of medicine and the variation in patient presentation, severity of illness, co-morbidity, etc., that are inherent to medicine make it the perfect nightmare for use in patient care unless it’s for the application of protocols and elimination of redundant information—not delivery of care at the bedside.

The EHR has become a cloning vehicle for upcoding, puffery and often copied but mistakenly not updated exams and treatment plans (my favorite is the “normal exam” template that doesn’t get edited to reflect the pathologic findings). That alone makes it a malpractice lawyer’s dream. There are so many moving parts and distracting, frivolous details that the forest obscures the tree you’re working on. Comprehensive data can be valuable for reference purposes, but to wedge the physician into the role of data-entry clerk is to guarantee errors, frustration, burnout, apathy and eventually resignation to a career never intended, or alternatively, to early retirement or a career change.

A return to paper may not be the answer, but excessive documentation requirements, combined with the method of data entry, and ultimately the information overload, will only doom our chances of revamping our healthcare system.

Dr. Michael Bryan

Southlake, Texas