Talking about EHRs and their respective utilization is much like making a blanket statement about cars or computers. It just can’t be done at that level. There are many organizations that would consider themselves live on an “EHR.” Truthfully most are somewhat using some EHR functionality. As humans we only use a small portion of the capability of the human brain and we live normal lives without using the rest. Most EHRs are used to some similar level but we have a capability to tap into more of that functionality that we have invested in.
Much of this functionality requires that front end effort be made to make the back end benefits evident. The effort is often not made based on lack of understanding or education of the necessary effort. Unfortunately, the sales pitch that sold the back end benefit did not explain the detail. This is not to place blame on the sales person, but to illustrate the necessity to read the manual.
Reluctance to change is amazing. It is beyond my understanding why as educated adults we think that results with EHR will happen so instantaneously without necessary effort. Nobody expects it to all change tomorrow, but give it some time it is truly a transformation. With EHR you can see some results and benefits very fast but making it all takes some time.
EHR projects require such an involvement from both the clinical and the IT side in a world where most things used to be handled on one side of the fence or the other. Now we are truly working on the fence. Unfortunately we tend to staff these projects by giving 20-30% of 20 individuals time to the project. I am not sure how the mathematical equation works but the manpower of those part time individuals, not dedicated to the project often ends up less than the 4 it should be. Personally I would take 3 teachable full-timers over 20 part-timers almost all of the time.
The way that we implement or utilize an EHR greatly determines its success. It is a large project deserving of an amount of forethought and effort correlated to the magnitude of the desired success of the project.