Health Information Exchange Featured Article

July 06, 2012

Cracks in EHRs? It's Not All about the Technology

Yes, the Affordable Care Act has been upheld, meaning most of the 30 million uninsured in America (almost 20 percent) will soon have health insurance. But some experts see cracks.

John W. Loonsk, MD, CMO, CGI Federal, is one. Writing at, he says that, though HITECH is firmly in place, it “was constructed from a health IT orthodoxy (set of tightly-held, common beliefs) that has shown a few cracks of late.”

Loonsk says that that’s because the population health IT needs of health reform come from a program (HITECH) that is mostly built “around individual patient transaction technology.”

He feels the fissures have developed from the view (which HITECH shares, he notes) of “EHRs as the center of the HIT universe.” And that’s probably because only EHRs, and not other aspects of HIT, “are the overwhelming focus of the incentive funds.”

Tie the Meaningful Use criteria to those funds and you’re looking at everything from an EHR perspective. “Either as cause or effect, criteria and leverage are pinned to EHR certification,” he writes. “It is almost as if all the other health IT systems in hospitals, much less other health related organizations, never existed and EHRs need to carry the entire burden of HIT expectations.”

Loonsk suggests changing “the orthodoxy” that has the country focused on funding increasingly more complex EHRs, and orienting it more toward the digital data itself, establishing an “ecosystem around high-quality, standardized data in exchangeable summary records, problem lists and care plans, etc. with whatever software was needed to get to them.”

EHRs are important for many reasons.   They provide a way for providers to coordinate care, patients to know their medical histories, and certainly not the least important, help doctors comply with new healthcare regulations.

Web site refers to a study published in the Journal of the American College of Radiology, CMIO first reported on, that found that physicians who use electronic health records to review portal images had better compliance with image review policies than physicians who reviewed images manually.

But what is the real point of EHRs? For too long, healthcare reform has revolved around the technology. But is that really what it’s all about, or people using data to connect with other people? At a blog put out by, Janet L McAllister of Simi Valley California, encapsulates it all.   “Electronic health records don't just automate workflow, they change the way people work—that is the hard part of the change!” she writes.

Edited by Rich Steeves