Electronic Health Records: Just around the Corner? Or over the Cliff?

Electronic Health Records: Just around the Corner? Or over the Cliff?
" We recently implemented a full-featured electronic health record
in our independent, 4-internist, community-based practice of general
internal medicine. We encountered various challenges, some
unexpected, in moving from paper to computer. This article describes
the effects that use of electronic health records has had on
our finances, work flow, and office environment. Its financial
impact is not clearly positive; work flows were substantially disrupted;
and the quality of the office environment initially deteriorated
greatly for staff, physicians, and patients. That said, none
of us would go back to paper health records, and all of us find
that the technology helps us to better meet patient expectations,
expedites many tedious work processes (such as prescription writing
and creation of chart notes), and creates new ways in which
we can improve the health of our patients. Five broad issues must
be addressed to promote successful implementation of electronic
health records in a small office: financing; interoperability, standardization,
and connectivity of clinical information systems; help
with redesign of work flow; technical support and training; and
help with change management. We hope that sharing our experience
can better prepare others who plan to implement electronic
health records and inform policymakers on the strategies needed
for success in the small practice environment.
Ann Intern Med. 2005;143:222–226. www.annals.org"