How the electronic health record did not measure up to the demands of our medical home practice

Abstract

The American Recovery and Reinvestment Act (ARRA) of 2009 will soon provide billions of dollars to small physician practices nationwide to encourage adoption of electronic health records. Although shifting from paper to computers should lead to better and cheaper care, the transition is complex. In this paper we describe our struggles to adapt a commercial electronic health record to an innovative practice serving high-cost patients with chronic diseases. Limitations in the technology gave rise to medication errors, interruptions in work flow, and other problems common to paper systems. Our experience should encourage providers and policy makers to consider alternative software and informatics models before investing in currently available systems.