JAMA Article Authors Report Resentment Against EHRs

“The secret of the care of the patient is in caring for the patient.” Although the statement, spoken nearly nine decades ago by Frances Peabody and published in The Journal of the American Medical Association (JAMA), may seem obvious, it actually remains quite profound. “The personal experiences of illness and the social context are as important as ever,” write Donna Zulman, MD, assistant professor (general medical disciplines), Nigam Shah, PhD, assistant professor (biomedical informatics) and Abraham Verghese, MD, professor (medicine). “Today, clinicians encounter a level of complexity—co-occurring chronic and rare diseases, organ transplantation, artificial devices—that has completely altered the practice of medicine.”

Although it’s intended as a tool that simplifies and streamlines, the electronic health record (EHR) is broadly considered to be one of these recent complexities.

Zulman, Shah and Verghese are authors of “Evolutionary Pressures on the Electronic Health Record,”a new opinion piece published in JAMA. In it, they contend that while EHRs have many virtues, they’re falling short of their potential and their counterparts in other industries. According to the authors, EHRs fail on a number of important measures, including inability to tailor treatment based on the patient’s unique characteristics or suggest a course of action based on outcomes for similar patients. They warn that EHRs are becoming “bloated records, devoid of meaning and full of cut-and-paste content.”

The result? Zulman, Shah and Verghese report “building resentment against the shackles of the present EHR; every additional click inflicts a nick on physicians’ morale... Better medical record systems are needed that are dissociated from billing, intuitive and helpful, and allow physicians to be fully present with their patients.”