As an EHR vendor and someone who has watched this industry mature over the past couple of decades, I have to say it is a little strange to me to even consider the question of whether EHRs improve care. As an industry, I think we have a tendency to take this as a matter of fact, but we shouldn’t. There is certainly substantial doubt in some quarters about the value of EHRs, and even we faithful know very well that EHRs could and should be doing much more to improve care. That "could" and "should" is the main focus of our work at VitalHealth.
Last month we saw a great deal of discussion surrounding a Journal of General Internal Medicine study. This particular study found a correlation between EHR use and a failure to adhere to proper care guidelines for certain behavior health conditions. Last week, another study emerged to say that doctors in New York State were seeing better adherence to screening guidelines for diabetes, breast cancer, chlamydia and colorectal cancer.
So which is it? Do EHRs improve or impede care?
As the president of Taconic IPA, John Blair said in his statement, “as with any health IT tool, an EHR is only part of the solution.” We could not agree more. While it may be that the EHR made it easier and more practical for providers to design a system that would automate screening reminders at the most opportune times, EHRs cannot take the credit for the improved screening compliance found in this study. The physicians are the ones that designed the program, set up the alerts and committed to changing their workflows to make those alerts work. While hopefully no one is blaming the EHR for the poor behavior care compliance seen in the JGIM study, I think there is a general expectation that EHRs should have a positive impact especially on things like complying with standard care guidelines. That, after all, is one of the main reasons for all of the investment we have all made in implementing and adopting EHRs.
The New York study and the stories our customers tell us are a testament to the tremendous impact a great EHR, well implemented and used by well-trained staff can have on quality and outcomes. It is our responsibility to make sure every customer has all of the features, functionality, resources, guidance and encouragement they need to get great outcomes.
There should be no doubt in anyone’s mind that EHRs are worth every penny and every drop of sweat they cost to get up and running, and it is our job to leave no room for such doubts to persist.