Nextgov

Even as hospitals struggle to meet the government's "meaningful use" requirements for electronic health records, another critical factor is emerging that could determine the primacy of EHRs: friendliness of use.

Across the country, doctors are aligning themselves with hospitals based on their preference (or dislike) of electronic records used at those institutions, reports bnet's Ken Terry in Hospital War: How the Federal Health-IT Program Works Against Doctors and Patients.

Tipping on the fulcrum of EHRs, doctors with privileges at multiple "open staff" hospitals are aligning themselves with a single facility.

One result, says Terry, is the acceleration of many health-care markets "into a few large health care organizations" and the subdivision of what has been a mostly disaggregated health care landscape into a system of "hospital-centric care" that could limit patient choice.

Hospitals, however, have no qualms about leveraging EHRs to lock up exclusive arrangements with doctors.

"Physicians are being forced to choose sides," concludes Terry. "Hospitals have found out that they can 'align' doctors with them by getting them on the same EHR as the hospital."

Elsewhere, Heath Umbach, writing on his Health IT Junkie blog, notes that community hospitals "are the true test bed for physician adoption of IT."

"Physicians struggle with systems that do not support their logical workflow and require them to provide information and respond to alerts that are better suited to other clinicians," says Umbach of systems that "consume additional time on their busy schedules."

Perhaps hospitals undertaking to adopt or upgrade electronic records should consider the friendliness factor: First, do no harm.