From The Editor: EHRs Taking the Long View

The arrival of authorized testing organizations and certified EHR products and modules help to answer the question of what is certified, and by whom. However, these arrivals bring other questions into sharper relief: Where does this leave sites that have already implemented an EHR? Are they better off waiting to see if their version of a vendor’s product gets certified, or scrapping it now for a guaranteed certified product?

In Jeff Byers’ story “EMR Implementation: One Day at a Time,” physicians in independent practices describe describe some of the travails of EMR/EHR implementation. These include having to update an EMR already in place because the subsequent version was certified, whereas their deployed edition was not. In at least one case, the advent of certification has upended a practice’s EMR update cycle. This same story estimates the cost of EHR implementation at $4 million to $5 million for smaller practices. Clearly time is money, and not just in terms of meaningful use incentives.

Practices have every right to balk at implementing something that might mean higher costs and fewer patients at the outset and uncertain returns down the road. But what strikes me about this story is the consensus among these physicians in the trenches that the move to electronic records is a good thing, in spite of the costs, the lost productivity and unexpected frustrations of implementation. They believe that they will reap the benefits of EMR use—if not now, then eventually. The long view is essential to getting buy-in among their more skeptical colleagues, and driving implementation forward.

The physicians in this story are in the majority, according to surveys by groups ranging from HIMSS to market research firms like KLAS and even underwriters. Lost productivity and up-front costs are real worries, but still, most physicians responding to these surveys said they believe EHRs will enable them to provide better care. Eventually.

Likewise, EHRs are integral to the patient-centered medical home model of care, as Justine Cadet describes in our story exploring the medical home model. They also will be the foundation on which longitudinal care and clinical decision support can achieve critical mass, as guest columnist Harris R. Stutman, MD, points out.

All that potential value doesn’t make an EHR any easier to install or close productivity gaps. But keeping a longer view of the benefits of EHRs is essential to forward momentum.