Speaking Out Against EHR Contract Gag Clauses

The promise of electronic health records (EHRs) has been stifled by many broken promises. Tedious hours of manual data entry and separation of doctor and patient during an encounter with a computer screen prevent the physician from spending quality time with their patients. EHR technology was — in theory — created to improve efficiency, quality and safety, yet many would say that EHRs are the leading cause of physician burnout today.

We often hear about high level complaints about EHRs from physicians, but a gag clause in most EHR contracts prevents users from talking publicly about specific issues.

If physicians and health systems cannot share and discuss the shortcomings of a new technology, how can we get better? What can we as CEOs and physicians do to solve this problem and make it more workable?

Welcome to The Clinical Divide. I’m Dr. Kevin Campbell, a Duke-trained cardiologist and CEO of the health data startup PaceMate. Every week, this Inside Digital Health™ video series examines healthcare technology and medicine’s top news. I bring the views that help physicians and healthcare executives bridge the clinical divide.

By now, you’ve all either heard about or experienced many of the problems associated with an EHR. When the use of an EHR system was mandated by the Hitech Act of 2009, it galvanized the industry and generated hundreds of millions of dollars in revenue for EHR companies. In order for an EHR to comply with the act, it must be used for the collection, display and storage of very specific diagnosis and treatment data. Much of the required data from this act are irrelevant to patient care or individual patients, but helpful to insurance companies, payors, government agencies and others that manage healthcare systems as a whole — basically it’s a billing system.

Most EHRs do not function as promised, and there are even examples of errors in data entry or data display and processing that have led to physicians unknowingly performing medically unnecessary procedures, or ordering expensive, unnecessary tests. However, gag clauses in EHR hospital contracts prevent users from talking publicly about their specific problems and shortcomings. So, how can we learn from our mistakes and get better if we can’t even talk about the problems we are facing?

We as CEOs and physicians MUST advocate for patients. We have to call out EHRs for what they are — billing machines. There has never been one study that has shown an improvement in patient care or patient outcomes with EHR utilization. That’s what the technology was initially designed for. It was designed for capturing billing. We must apply pressure on EHR companies and must demand that our government officials and agencies hold these companies accountable. We must negotiate better contracts with EHR providers, and no healthcare system or healthcare professional should ever be required to remain silent about issues that can negatively impact a patient when it comes to technology. It is never acceptable for the users of a healthcare technology to not be allowed to discuss shortcomings or failures associated with things such as EHRs — we do this among ourselves at our national meetings. If we remain silent, our patients suffer and innovation stalls.

Thank you for joining me for this episode of The Clinical Divide. Until next week, I’m Dr. Kevin Campbell, for Inside Digital Health™.

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