How doctors can get out of EHR purgatory

Jeff Rowe
How doctors can get out of EHR purgatory

Widespread implementation of EHRs has been declared a historic step forward for the healthcare sector, but it’s no secret that many physicians aren’t happy with their new technology.

Writing recently for the New England Journal of Medicine, Allan H. Goroll, M.D., an internal medicine physician at Massachusetts General Hospital (MGH) in Boston, says physicians are stuck in “EHR purgatory.” 

As he sees it, while physician practices and hospitals have turned to short-term solutions to the demands of EHRs in the form of voice-recognition software and medical scribes, the best solution would be a significant shift toward value-based payments that forced EHRs to evolve into a more patient-centered, and doctor-friendly, tool.  

“Clinician entries could be complemented by a patient-generated functional status report and set of personal care goals,” he wrote. “Such an EHR would begin to take on the look and feel of an essential instrument of patient care and population health management rather than a billing statement.”

Goroll points to accountable care organizations that have successfully implemented risk-based payment models along with isolated provider-payer collaborations that emphasize value. But he admits that broad reforms are “likely to trigger considerable discomfort and resistance” since hospitals and physician practices have invested significant time and money into the current EHR systems.

“These groups argue that paying for outcomes could be achieved with less disruption by simply grafting some value-based payments and penalties onto a fee-for-service model,” he says, but that would do “ little to reduce documentation burden or correct the misplaced emphases on care processes and service volume.”