Despite the boon provided by EHR, the path forward is far from free of bumps.

In May, a Penn Medicine study appearing in the New England Journal of Medicine found that the current setup of EHRs has led to greater physician work load, higher risk for burnout and an increase in other challenges it was meant to fix.


"I think that firms have created platforms that focus almost entirely on the technical task of making medical records digital and not the design task of making them useful," senior author David Asch, executive director of the Penn Medicine Center for Health Care Innovation, told HCB News. "You end up creating something that looks very much like a paper chart. If you focus on the task of making electronic records more useful and think about what people really want from them, you can create something even better.”

Physicians, according to Asch, often feel that more effort is required in using EHRs, and see very little improvement compared to paper charts.

“Many elements of health care are now effectively algorithmic,” he said. “For example, there are clear guidelines on which patients should be on statins to lower their cholesterol. There are guidelines for who shouldn't get advanced imaging for low-back pain or who should stop their proton pump inhibitor. Nudges can also move electronic records beyond paper charts, and they may advance value-based care models far more effectively than traditional approaches of education-based decision support.”

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