Rocky road in EMR/EHR path to adoption, interoperability

Interesting happenings in the EMR/EHR arena recently and not all good.

For one thing, a study published in JAMA Internal Medicine found no association between EHR meaningful users and quality of care provided.

The researchers assessed whether being a meaningful user, as defined by meeting 15 core objectives as well as meeting 5 of 10 optional menu objectives, was associated with improved quality on seven measures for five chronic diseases. The study followed 858 Brigham and Women’s Hospital physicians using the same advanced EHR during a 90-day reporting period in 2012. Of these physicians, about 63 percent were considered meaningful users of their EHR systems.

No association was found between MU of EHRs and quality. Overall, the meaningful users performed “marginally” better for diabetes and hypertension, marginally worse for asthma and depression and no better or worse for the other measures, according to the findings.

In another development, athenahealth has parted ways with the EHR Association (EHRA). “At the end of the day, athenahealth left the EHRA because we never really belonged there in the first place," wrote Dan Haley, vice president of government affairs, in a blog post. He said that athenahealth is neither an EHR company nor a software vendor, but the defection does raise questions about the association’s goals and membership.

Just this week, Jacob Reider, MD, the Office of the National Coordinator for Health IT’s chief medical officer, spoke at the Medical Informatics World Conference saying that EHR “usability is not where it needs to be.”

Much of the latest technology aims for a pleasurable experience, he said, such as autocompletion of texts and the user interface of the iPhone, which anticipates users' needs. However, “maybe it’s not safe.” For example, the autocomplete function could incorrectly finish the name of a drug. “Safety is an important component of usability. We want users to derive pleasure but it’s more important that they be safe.”

Physicians might complain that technology is too slow, but Reider said that could be a good thing. “Sometimes slow is better,” especially when it forces users to double check their selections.

The latest developments represent a wide range of activity in the EMR/EHR arena and I'm sure we'll see still more as the industry continues to evolve.

Beth Walsh

Clinical Innovation + Technology editor