EHR system users, doctors and other healthcare providers were blindsided by this records lockdown and its subsequent burdens. Nowadays, patients expect the seamless integration of their records and are miffed when told that their electronic charts first need to be printed out, faxed and then scanned into your system’s record. This cumbersome procedure is repeated in reverse when they return to their primary care doctor.
Interoperability is at the core of a functioning system. Yet according to one government report, in 2015, a mere 56% of hospitals had received electronic records from other practices—and just 40% of those had successfully merged the information into their own databases.6 Instead, EHR companies consider interoperability a threat to their business models and have delayed the full integration of medical records until the next decade. The founder of the largest EHR company has been quoted as saying: “Do good. Have fun. Make money.”6 EHR executives sure have; she, along with an executive from a rival company, made the Forbes magazine billionaires list.7
Although EHR executives may rejoice, some experts in health information technology have been forthright about the troubles with their products. A recent mea culpa penned by two of them summarized the fallout from the disastrous rollout of the EHR:8
“Along the way, however, we lost the hearts and minds of clinicians. We overwhelmed them with confusing layers of regulations. We tried to drive cultural change with legislation. We expected interoperability without first building the enabling tools. In a sense, we gave clinicians suboptimal cars, didn’t build roads, and then blamed them for not driving.” Touché!
Some readers may look back at paper records with a sense of nostalgia. They contained personal observations of the patient visit, scribbled free of the modern template dribble. Office notes were short, succinct and usually to the point. No need to meet the yet-to-be created Meaningful Use parameters.
There may have been an additional benefit to using paper charts—they were not likely to be hacked and held for ransom. A recent spate of EHR hacks has demonstrated how vulnerable some of these systems may be to thieves. This past May, the aptly named WannaCry virus attacked the venerable British National Health Service, shutting down more than 40 of its districts and hospitals. Other hacks have attacked the Presbyterian Medical Center in Hollywood, Calif., and the MedStar Health system that operates in Maryland and the District of Columbia.9 Long live pen and paper!
EHR companies consider interoperability a threat to their business models & have delayed the full integration of medical records until the next decade.
PBM Chicanery
One day soon, the inner workings of PBMs, the dominant gatekeepers to prescription drug access in America, may be revealed. Working under cover of darkness, they have antagonized many of their stakeholders, including the biopharmaceutical companies, health insurers, pharmacies and patients. Myriad complaints leveled against their business practices have caught the attention of Congress. That is never a good thing.
