Robert Wah, MD, will soon be sworn in as president of the American Medical Association. Dr. Wah, board certified in reproductive endocrinology, obstetrics and gynecology, also is a nationally recognized expert in health information technology, currently serving as CMO of Computer Sciences, a health IT consulting firm.
In a Medscape article, Dr. Wah offered his thoughts and insights — speaking on behalf of CSC — on electronic health records and why they are essentially a good thing, though he acknowledged setbacks and obstacles that need to be resolved before the healthcare industry can reap the benefit of EHRs.
Here are five thoughts from Dr. Wah on EHRs.
1. The government is demanding too much from EHRs, making it more difficult for physicians to sort through data and adhere to reporting programs. The EHR wasn't designed for all the functions the industry is trying to impose on it. "The reason why most physicians started their records was to keep a record of what they saw and did and to be able to communicate that to other physicians. But now healthcare has put all these other demands on that same record: It's supposed to code, it's supposed to be a basis for reimbursement, it's supposed to be used for reporting quality. And what started out being very straightforward has become very complicated," Dr. Wah said in the report.
2. Overlapping federal programs only add to the confusion. Dr. Wah mentioned programs such as the e-prescribing program, meaningful use and the Physician Quality Reporting System that all have different timelines, incentives and penalties, making it difficult for physicians to keep each straight. Dr. Wah previously supported a proposal to combine meaningful use, PQRS and the value-based modifier program into one integrated system, but Congress did not pass it.
3. To improve ease of use, EHR vendors should improve user interface. Dr. Wah said the main complaint physicians have about EHRs is a poor interface and difficulty in data visibility. The EHR needs to be a tool that enables more efficient work, ultimately resulting in better patient care, he said.
4. EHRs can improve physician-patient interaction, not detract from it. Hospitals have attempted to diminish the perceived interruption to physician-patient relationships by positioning computers in such a way that physicians don't have their backs to patients, for example. However, Dr. Wah said there are areas to significantly improve the relationship between patients and physicians surrounding the EHR instead of simply mitigating potential obstacles. "Electronic systems allow us to have simultaneous access to the same information, so we can rework the workflow and make things different and more efficient in the process of seeing the patient," he said in the report. The EHR allows for a joint look at patient data and solicits a more interactive discussion.
5. EHRs will eventually lead to overall increased quality. Many clinicians have their doubts, but Dr. Wah said once user interfaces are improved and EHRs are deeply integrated into the process of care, they will help increase clinical quality. Hospitals should standardize the EHR's clinical decision support to reduce care variation and follow best practices. "One of the opportunities that digital platforms and electronic tools can give us is that if we can agree on what the right thing to do is, we can use these tools to make the right thing the easiest thing to do," he said. "That will enhance our ability to do the right thing."
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