Monday, November 13, 2017

Excellent Synopsis of the History of the Electronic Health Record

The HITECH Era in Retrospect by John D. Halamka, M.D., and Micky Tripathi, Ph.D. is an accurate description of the introduction of computerized technology into the medical arena. It is must read for all providers.

Wikipedia states “John D. Halamka is a physician who focuses on the adoption of electronic health records and the secure sharing of healthcare data for care coordination, population health, and quality improvement.” His C.V. emphasizes his credibility.

The multiple blogs co-authored by myself and Dr. Kamens reflect multiple story lines brought up by Dr. Halamka as the benefits and deficits of the Electronic Health Record.

As Dr. Halamka points out, a big factor in the evolution of a tool that should help, but instead harms (thus not in the manner of primum non-nocera) has been government intervention into a process they little understand.  Given oversight throughout the evolution of EHR requirements have been office people, desk sitters, academicians, and others who have little or no actual clinical experience.

As a result, the guidelines through upon which developers have created the software that runs EHRs have been disconnected from real clinical needs and utility. Despite all the negativity, there is hope the electronic interface can be adjusted to the needs of the provider and not just to endless data collection. That however, as noted in the article, will require a commitment to involving providers in creating practical ways to do things better.

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