10 Years + $31B = An Unholy Mess

Or at least that is what an investigation by Fortune and Kaiser Health News reported in an article titled: “Death by a Thousand Clicks: Where Electronic Health Records Went Wrong“.

The article focuses on healthcare where the American Recovery and Reinvestment Act (ARRA) of February 2009 was supposed to make information management in healthcare a more streamlined by making patient records more accessible and give more time back to clinicians to focus on their patients.

This led to a surge in electronic healthcare records (EHR) software solutions with poor user interfaces, lack of standards, and little to no interoperability between them. In this regards, the article points out that “Instead of reducing costs, many say EHRs, which were originally optimized for billing rather than for patient care, have instead made it easier to engage in “up-coding” or bill inflation (though some say the systems also make such fraud easier to catch)”.

While the concept of the ARRA is sound, and with good intent, the execution of it was poorly planned if planned at all, and certainly the rush to provide EHR solutions missed the mark on usability, quality control, and adaptability. According to an American Journal of Medicine study, an ER Doctor will make approximately 4,000 computer clicks during a single shift and the Annals of Family Medicine cites that out of an 11.4 hour day, Doctors are spending more than 5.9 hours of time working in an EHR applications as opposed to 5.1 hours with patients.

In My View

This is a prime example of well intentioned legislation gone afoul. In order to legislate something of this magnitude, there should be an awareness of what the impact will be overall, guidance on the intent and a base set of requirements that can be considered standards, and emphasis on usability at the user level.

When government – or C-Level management for that matter – decide to move forward with an overarching mandate like ARRA, it is their responsibility to at minimum, understand the reality of what is in place, what it will take to reach their goal, and the impact it will have within the user community.

It is not a bad thing to initiate efforts to simplify and standardize but it is a bad thing to shoot in the dark with hopes of hitting the mark.

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