Physicians, we hear you: EHR meaningful use isn't meaningful

Steven J. Stack, MD , Former President

The message from physicians is loud and clear: Electronic health record (EHR) systems have so much potential, but frustrating government regulations have made them almost unusable.

Atlanta-area physicians told me this firsthand Monday in the AMA’s first-ever town hall meeting on EHRs and the meaningful use program. Rep. Tom Price, MD, from Georgia’s sixth district, joined me to listen to physicians’ everyday challenges with EHRs and burdensome government regulations that detract from patient care. About 500 other people registered to watch the event via live-streaming.

As an emergency physician, I experience my own struggles with my hospital’s EHR system. But I wanted to hear from physicians in all specialties in a live venue that would enable policymakers to hear their concerns firsthand and unfiltered. Not surprisingly, it turns out that we’re all struggling.

For example, Melissa Rhodes, MD, a Georgia physician in pulmonary critical care and sleep medicine, is fed up. She was an early adopter of the technology, implementing her first EHR in 2006, more than three years before the meaningful use program was created in legislation. She wanted the system to live up to its promise—but that didn’t happen.

“I don’t think we’re going to do meaningful use Stage 2,” she said at the town hall. “And we’ll take the penalty.”

Dr. Rhodes tallied up how much her three-physician practice has spent on her EHR and related IT costs—over the past year, that number hit $84,000.

But more important than the costs, Dr. Rhodes’ EHR has limitations that affect her patients. The system won’t allow her to titrate orders for patients in the intensive care unit. And she has to personally enter orders, no matter what time of day or night, without being permitted to benefit from the help of nursing colleagues at the hospital.

“There are so many orders you can’t put in,” she said. “It only leads to harm for patient care, and more medical errors—not less.”

Dr. Rhodes’ story sounds like so many others we heard at the town hall: Physicians are trying to use EHRs to improve patient care, investing a lot of time and money into making them work, but they are being thwarted.

The goal of the meaningful use program was to encourage physician adoption of EHRs. This has been accomplished. Today, more than 80 percent of physicians have implemented some form of EHR system. But we’re not getting what we expected from this technology.

As physicians, we had hoped that these tools would help facilitate patient engagement, reduce administrative burdens and promote the exchange of data. Those three things have definitely not happened. Instead, we’re dealing with systems that won’t talk to one another, cost too much to maintain and require us to spend an inordinate amount of time entering data instead of helping patients.

The consensus Monday night was that EHRs do not give accurate information in usable forms. Without this, they cannot and will not improve the quality of care.

A top priority for the AMA, just as it is for Dr. Rhodes, is ensuring that our patients’ clinical needs and those of the clinicians providing their care are given greater importance than meeting federal regulations. Based on our study with the RAND Corporation, we know EHRs are a major driver of physicians’ dissatisfaction with their practice environments. As a result, we worked with doctors and other experts to create eight priorities for making EHRs usable. These priorities continue to serve as a guide for our activities with vendors, policymakers and health care systems.

That’s why I need you to share your story with us. Please help us take this viral with a groundswell of physician input to inform D.C. policymakers. Please tell us your EHR experiences and stories—how EHRs and current meaningful use regulations have impacted your practice and the care you provide your patients. Then, email your members of Congress and ask them to halt Stage 3 of meaningful use until the program is fixed.

We need policymakers to hear our stories and take action, which is why I’m so pleased Rep. Price was able to listen firsthand. Despite plans to realign several government reporting programs, including meaningful use, the government seems poised to do so without addressing these issues first. We need regulators to hit pause, fix the problems and make the meaningful use program actually meaningful.

Please visit to watch the town hall meeting, share your stories about EHRs and meaningful use, and contact your members of Congress. Help us get the government to listen.