Fatal EHR flaw — little thought given to physician users

Regarding “Doctors strike back at EHR vendor with class-action suit” (Article, May 6):

I recently attended a meeting on Medicare changes and health information technology. The handout was neat, comprehensive, timely and in color. Unfortunately, the printed slides were so small as to cause eyestrain; they were impossible to read. This is exactly what is wrong with the current state of electronic health records in the United States. Let me illustrate:

In the summer of 1940, England stood alone against Nazi Germany. In the Battle of Britain, a small number of brave British fighter pilots successfully turned back the German air attacks. One of the English planes used was the Hawker Hurricane, but it had one problem: The engineers designed it with the fuel tank in the fuselage, right in front of the pilot’s seat. As a result, any time the gas tank was perforated by the enemy’s red-hot bullets, it immediately engulfed the pilot in flames.

The whole point of this letter is this: As currently designed, EHRs are not tools that busy physicians can use efficiently in their practices. The makers of EHRs have ignored the inherent limitations of human physical and mental capabilities in their designs, as well as what doctors actually do all day long (i.e., patient encounter work flow). Simultaneously, government regulators and health care insurers and administrators have demanded, incrementally, more and more physician medical record documentation that is the equivalent, to use a sports analogy, of expecting every player on a team to break current world records by 5% every year!

In focusing on their own priorities and needs, all the nonclinicians involved in the whole EHR movement in this country are not considering, systematically, the affect and effect of their decisions, both individually and in summation, on the end users. As a result, physicians are being burned out at a record pace.

— Calvin J. Maestro Jr., MD, Oscoda, Mich.