In response to Jean DerGurahian's Experts say usability absent from adolescent EHRs":
I read Jean DerGurahians article with a great deal of interest and appreciation for articulating one of the major problemsthe "one-size-fits-all" approach that software vendors have taken in developing electronic health-record solutions.
As a member of a consulting firm that has worked with healthcare agencies on accountability and quality improvement issues for the past decade, our searches through clinical records for valid performance data that could form the basis of valid reports with useful recommendations was an extremely time-consuming and challenging task.
No comments are needed with respect to how difficult this task is if the healthcare agencies maintain paper-based files, though, admittedly, a few do have good paper-based processesalbeit ones that prove to be very labor-intensive and extremely expensive.
But, even in those instances where there was utilization of computer-based clinical records, they were largely transactional in nature (e.g., clinicians would log on to the system to provide clinical notes that would also generate the billable hours for management) and had little to do with the quality of patient care resulting from the billable hours." The clinicians who made these entries generally saw no relationships with patient care; rather they said that it was done for administration and finance purposes."