Posted by: Tony Shannon | July 31, 2019

Lost in Translation : EHR State of the Market update

As a healthcare improvement/tech advocate am regularly willing and able to declare that the Electronic Health Record (EHR) market is not as good as it should be, at all, so we need an open collaborative approach, internationally, to make it better.

Some related articles that help explain the latest state of the EHR state of the market.

“EHR Sales Reached $31.5 Billion in 2018 Despite Concerns over Usability, Interoperability, and Ties to Medical Errors”

So big sales and increasing all the time, albeit with the usual caveats about the related challenges therein

#1 Interoperability as well as other common criticisms of EHRs cited include:

  • Wasted provider time: a recent study published in JAMA Internal Medicine notes providers now spend more time in indirect patient care than interacting with patients.
  • Physician burnout: EHRs have been shown to increase physician stress and burnout.
  • Not worth the trouble: The debate continues over whether EHRs are improving the quality of care.
  • Negative patient outcomes: Fortune’s investigation outlines patient safety risks tied to software glitches, user errors, or other flaws.

On a related noted, as if further evidence were needed that the main challenges in this field are people + process as much as technical.. check out this “Culture eats Strategy for Breakfast” type article on attempts towards a major EHR rollout in Denmark.

Lost in translation: Epic goes to Denmark

TLDR: the key points are perhaps best summarised by this Tweet by informatician of long standing Enrico Coeira



  1. Can we call EHRs by what they really are: EBS – electronic billing systems. The clinical stuff supports billing as its top design priority rather than supporting the health of the patients, much less that of the users. The one major system that was designed with patient CARE in mind and didn’t even have billing as part of it until many years later is CPRS, the EHR of the Veterans Health Administration in the US. It has its problems to be sure, but trainees who work in more than one hospital and thus deal with two different EHRs consistently rate CPRS more highly. (And now VHA is transitioning to a commercial product, albeit with some reasonable justification.)

    • thanks David, fair comment.
      Usability of the EHR is key/central challenge to the future of this field.. clinicians need to raise their voices on this..
      thanks, Tony

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