Electronic Health Records Pros, Cons Debated by Otolaryngologists

BOSTON—Michael Seidman, MD, director of the division of otologic/neurotologic surgery at Henry Ford Health System in Detroit, shared a few opinions about electronic health records (EHRs) that were posted on the American Academy of Otolaryngology-Head and Neck Surgery’s “ENT Connect,” an online member network, with audience members of a panel session presented during the April 2015 Annual Meeting of the Triological Society, part of the Combined Otolaryngology Spring Meetings.

While EHRs might allow for more thorough data acquisition, there is a “risk for mass loss of records,” wrote one poster. A properly designed EHR can be “extremely useful,” but the problem lies with “meaningless use,” wrote another, referring to federal meaningful use incentive requirements. Meaningful use stage 2 requirements are “beyond ridiculous,” said another.

The posters are not alone in their impressions of EHRs. The panel discussion, which Dr. Seidman moderated, touched on the pros and cons of EHRs, their impact on patient safety, the federal regulations surrounding them, and professionalism in using them.

Pros and Cons

Susan Cordes, MD, an otolaryngologist with Ukiah Valley Medical Center in California, said two of the biggest cons of an EHR system are time and money. “It’s a huge investment,” she said. “And then, once you get it up and running, it’s still not perfect. The computer goes down, and it ruins your entire office for the afternoon and drives your patients and staff crazy.”

Additionally, she said, interoperability is “way too low.” EHRs are not made for the efficiency of physicians but for compliance and billing purposes, she said. Plus, face time with patients is hindered.

On top of all this, quality of communication can actually be hampered by the amount of data. “This is probably one of my biggest pet peeves with the computer system: All this auto-population, and meaningful use and compliance, makes this huge patient chart that suddenly becomes meaningless because you can’t find what you’re looking for,” Dr. Cordes said.

The pros of EHRs, she said, are that they are space-efficient, and paper could be saved “if we can decrease the reliance over time.” Also, while paper charts are gone forever when lost, computer records can be backed up. Computers, she added, are evolving and have “a lot of room for improvement,” whereas paper charts have “hit their peak.”

She said it’s important to be part of the improvement process and communicate with legislators about physicians’ issues with the current EHR situation. “The pressure should come on interoperability and making the systems better for patients and for providers,” she said.

Patient Safety

Brian Nussenbaum, MD, patient safety officer in the department of otolaryngology-head and neck surgery at Washington University School of Medicine in St. Louis, Mo., said EHRs can improve patient safety—with easier access to information, by improving communication and with computerized physician ordered entry (CPOE).