Podcast: Breaking Silence and Fixing the EHR

The electronic health record (EHR) is tangled with clinician burden, extraordinary cost and patient risk. The EHR is also nearly ubiquitous in the U.S. healthcare system, having dramatically spread its grip through a $35 billion government incentive program. Given the wide-reaching adoption of the EHR and the pain it has brought, it’s critical that health systems find a way to make the technology work in the interests of patients, physicians and the enterprise.

That’s the issue at the heart of this episode of Data Book, the first installment of our fourth season. By the time you finish this episode, you’ll understand some of the potential of EHRs and how they’re failing doctors and patients. Finally, you’ll receive some insights as to how health systems, physicians and vendors can work together to improve the EHR.

We examine this issue through the story of guest Jesse Ehrenfeld, M.D., MPH, an anesthesiologist and biomedical informaticist who sits on the American Medical Association Board of Trustees. Ehrenfeld graciously takes us through his history with the EHR, technology and the clinic, highlighting several instances that showcase the potential benefits and all-too-real deficiencies.

Consider last year’s AMA-sponsored study that found unsettling variability in EHR usability and patient safety. Is it acceptable that physicians in some hospitals make 14 clinics to order Tylenol for a patient, while doctors elsewhere must click more than 60 times? Further, are healthcare leaders OK with the consequences of wild EHR variability — patient harm?

On the other hand, real-time notifications have prevented an unknown number of clinical errors. How else, if at all, might the EHR be used to actually improve medicine and physicians’ lives?

Healthcare won’t have an answer to that question unless stakeholders from across the industry collaborate to overcome EHR challenges.

The first thing that must happen, according to Ehrenfeld: Vendors need to follow user-centered design practices. But implementation is also key — and this is an area where health systems and vendors often stumble. Of course, physician and clinician input must influence the set-up of the technology.

There’s more to this challenge, and we dive a lot deeper in the episode. Be sure to check it out. Come for the insights and stay for the story. And don’t hesitate to let us know your take on Twitter, LinkedIn or Facebook.

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