Electronic Health Records Are Broken

A team of investigative reporters recently released a scathing analysisof the Obama administration’s decade-old push to digitize patient health records. The report, conducted by Fortune Magazine and Kaiser Health News, revealed that electronic health records were responsible for thousands of serious, even fatal, medical errors.

Needless to say, this wasn’t what the Obama administration promised. President Obama claimed that EHRs would mean, “less paper-pushing and lower administrative costs, saving taxpayers billions of dollars.” He added, “it will also mean all of you physicians will have an easier time doing your jobs . . . It will reduce medical errors.”

A decade later, the opposite has proven true. EHRs have led to unnecessary deaths, contributed to a steep drop in doctor-patient interaction, and yielded little to no cost savings.

The EHR push started with the 2009 American Recovery and Reinvestment Act. President Obama approved billions in spending to encourage the healthcare industry to embrace the technology. Doctors and hospitals who failed to adopt a government-approved digital system by the end of 2014 faced cuts in their Medicare reimbursements.

So providers rushed to implement EHRs. Ninety-six percent of hospitals have EHR systems today, up from 9% in 2008. Most doctorsadopted them as well.

But these EHRs ended up being seriously flawed—and dangerous for patients.

For one, patient records routinely have errors. In one survey, 21% of patients reported mistakes in their own electronic medical records. In some cases, when a physician pulls up a patient profile, the system displays a doctor’s note for a different patient.

Other issues abound. Systems are supposed to flag potentially dangerous drug orders but often fail to do so. Records frequently don’t list the correct start and stop dates for prescriptions. And transmitting data between systems is a huge challenge.

Consequently, the recent Fortune-KHN investigation revealed, “alarming reports of patient deaths, serious injuries and near misses—thousands of them—tied to software glitches, user errors and other flaws.”

More than 3,000 medication errors at pediatric hospitals from 2012 to 2017 were due in part to EHR problems, a study in Health Affairs found. About one in five of these could have caused patient harm.

A 2016 test simulation of hospital EHRs revealed that, in roughly four in ten cases, the system failed to detect potentially harmful drug orders. Of those, 13% could have been fatal errors.

Consider just one EHR horror story relayed by the Fortune-KHN report. A patient came to the emergency room suffering severe headaches and a high fever. The doctor ordered tests to check the patient’s spinal fluid for viruses. But the order, entered into the hospital’s EHR system, never made it to the lab because it couldn’t connect properly with the lab’s software. As a result, the tests happened too late—and the patient suffered irreversible brain damage.

These errors alone are enough to prove that the EHR mandate did far more harm than good. But they’re not the only negative consequences electronic health records have wrought for patients and doctors.

For starters, patients get less face time with health professionals. Two-thirds of doctors say EHRs reduce the amount of time they spend with patients. In fact, physicians dedicate half of their working day to EHRs and paperwork.

Beyond lost time, these administrative headaches overwhelm doctors. More than three-quarters of doctors report symptoms of burnout, according to a Merritt Hawkins survey. Many of them point to the EHR mandate as the primary cause.

Burnout can increase doctors’ risk of making mistakes and reduce patient satisfaction. It can also push doctors to leave the profession. More than four in ten doctors plan to switch career paths. Half would not encourage their children to go into medicine.

The United States is already projected to be short nearly 122,000 physicians by 2032, according to the Association of American Medical Colleges. We can’t afford to lose the doctors we have—much less dissuade others from entering the field—by making the practice of medicine miserable.

The supposed savings from EHRs have also been illusory thus far. Experts estimated that switching to electronic records would save the country about $80 billion a year. But more than four in ten doctors say the EHR mandate increased the cost of care at their practices. Only one in ten report savings.

Electronic health records were supposed to improve the practice of medicine. Unfortunately, these records have broken care for doctors and patients alike.

Nothing contained in this blog is to be construed as necessarily reflecting the views of the Pacific Research Institute or as an attempt to thwart or aid the passage of any legislation.

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