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EHRs Rush in Where Doctors Fear to Tread

Scott Mace, for HealthLeaders Media, March 21, 2013

This article appears in the March 2013 issue of HealthLeaders magazine.

Resistance to new technology may be futile, but it remains an issue for healthcare.

"Physicians do have to spend more time at computers now, which diminishes the amount of time we can spend at the bedside and interacting with patients and actually doing those things like surgical procedures and interventions that only we have the skill and the knowledge and the training to do," says Steven J. Stack, MD, chairman of the board of the American Medical Association.

Stack, who also heads the AMA's health information technology advisory group, says physicians flock to new technology when it helps them provide better diagnosis or treatment in a more timely fashion. "Just look at robotic surgery," Stack says.

But Stack faults the rush to deploy electronic health records for much of the continuing resistance to tech. "There are poor user interfaces with clumsy drop-down menus [and] a one-size-fits-all approach to the documentation process," he says. "As you would imagine, the documentation for an ophthalmologist focusing their entire professional life on a few centimeters of the human body contained in the eye is very different from a general internist taking care of the entire wellness of an entire human being."

As recently as 2007, the majority of all outpatient care in the United States was provided by physician group practices of fewer than three or four doctors, Stack notes. "There's no IT staff or CIO in the office," he says. "The CIO is either the physician themself or the practice manager. That's a real problem. And the cost to upgrade and maintain and troubleshoot is enormous."

While the industry scrambles to equip each provider with its own interoperable electronic healthcare system, what can be done to counter such fears and resistance? A wide range of providers says the answer lies in changing the culture of organizations, and even sometimes resorting to flashy incentives such as giving physicians iPads.

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