EHR’s: Healthy Relationships, Not Health Records

Posted on | August 6, 2010 | Comments Off on EHR’s: Healthy Relationships, Not Health Records

Eric Dishman

It’s been eleven years since my Intel colleague, John Sherry, and I first did some fieldwork studying physician practices and hospitals that were in the throes of choosing, installing, and/or experiencing EHRs (electronic health records) for the first time. Most interesting to me of these studies has been when we could get in to a practice in the earliest stages–something I have now witnessed in probably 20 different organizations–when, usually, a tech-savvy doctor or passionate clinical operations manager begins championing the EHR cause and trying to pull everyone else along, usually, kicking and screaming. Time and time again, I have seen the process become so bogged down in the minutia of databases, software features, interoperability, ontologies, and codes that the intrepid pioneers ran out of energy, capital, or political capital with their colleagues before getting anywhere near the Holy Nirvana that EHRs were supposed to deliver unto them.

Over the past few months, I’ve visited many states and practices who are experiencing this kind of culture shock in the midst of national carrot-and-stick health reform programs around investments in EHRs, meaningful use deadlines, and payment reforms. And I am left more than a little worried that in our zeal to create the internet for health–a goal I certainly believe in–we are becoming, once again, too focused on the minutia of health records, with too little attention focused on the healthy relationships among doctors, nurses, health workers, and families that we want this infrastructure to enable. I find myself even as the “tech company guy” asking these practices: What care models are you trying to enable? What problems are you trying to solve? What are the new kinds of relationships you are trying to prioritize in your practice? Too many of them can’t answer these basic questions…or they have so many answers that no one technology could ever hope to solve so many problems.

So here’s some “free advice” (remember that you get what you pay for!) based on the many EHR adoptions I have now witnessed: (CONTINUE….)