Thursday, June 23, 2016

New AMA President Andy Gurman, MD on EHRs: " I don't have one, and no one can make me use one."

The love-fest with EHRs continues, to the great chagrin of the believers in fairies, unicorns and cybernetic utopia.

Andy Gurman, MD, Takes Reins as AMA President
Jun 17, 2016
Gale Scott, HCPLive

The American Medical Association’s new president, Andrew W. Gurman, MD, known for his affability and quick wit, is not one to seek out controversy.

In an interview before being sworn in this week as the AMA’s annual meeting in Chicago, IL, Gurman said he has no agenda for his tenure at the top of the organization.

Considering the mass hatred of EHRs by physicians (and nurses), the issue of EHR-related harms, compromised patient data security, physician scorecards, and other noxious issues, maybe he should have an agenda.  E.g., see my Jan. 28, 2015 post "Meaningful use not so meaningful: Multiple medical specialty societies now go on record about hazards of EHR misdirection, mismanagement and sloppy hospital computing" at

... Though physicians’ anger over the frustration of using existing electronic health records was a major topic of conversation at the [annual AMA] meeting, Gurman said he had little to add other than no one could make him use one.

 “I don’t have an EHR,” he said. Due to the fact that he runs his own practice he found it easier and cheaper just to forgo the enhanced payments he would get under the federal “meaningful use” regulations for converting to electronic records. “I just take the penalties,” he said.

Not every physician can afford the time sink most EHRs represent, and the increasing penalties for non-users, unfortunately.

Perhaps on the AMA agenda should be a return to sense regarding physician and nurse documentation, with significant reduction in their clerical burden for starters.

-- SS


live IT or live with IT said...

At least he seems awake.

Anonymous said...

The AMA has failed its members by not organizing strategic opposition to the EHR scourge.

Bruce Wilder MD said...

Dr. Gurman has it half right. But organized medicine, including the AMA, missed the boat when it outsourced health IT. For details, see

The EHR is an integral part of medical care. The medical community, including organized medicine, has yet to explicitly recognize this concept. Legislation was introduced in 2008 that would have made EHRs available to physicians at nominal cost, and which would have provided an avenue for innovation from the ground up, i.e., by end-users. It is unclear to what extent effective input from the medical community might have prevented the demise of this legislation. Instead we got HITECH, which included incentives for adoption of EHRs by providers. That came about because of intensive lobbying by the EHR software industry, which was the real beneficiary of the “incentives,” and probably slowed the efficiency and effectiveness of EHRs by a decade or two. These same “incentives” justified the meaningful use requirements – benign-sounding enough, but as it happened, an example of bureaucratic interference with medical practice gone off the rails.

InformaticsMD said...

Bruce, agree with all here and at your libk, with one addition. It's not just MU requirements and lack of interoperability that are the problem. It's bad health IT more generally.

Bad Health IT is defined as IT that is ill-suited to purpose, hard to use, unreliable, loses data or provides incorrect data, is difficult and/or prohibitively expensive to customize to the needs of different medical specialists and subspecialists, causes cognitive overload, slows rather than facilitates users, lacks appropriate alerts, creates the need for hypervigilance (i.e., towards avoiding IT-related mishaps) that increases stress, is lacking in security, lacks evidentiary siundness, compromises patient privacy or otherwise demonstrates suboptimal design and/or implementation.

An entirely unregulated, monopolistic industry with highly inappropriate talent management practices, over decades, combined with a vacuum of true medical pushback and opposition, among other factors, led us here.

I am not sanguine that current efforts to "fix" extant products will accomplush very much, either.

Shelley Adams said...

"... with highly inappropriate talent management practices"

No kidding!

I severely doubt anything will get fixed as long as the health IT talent pool remains limited to IT professionals with [arbitrary time period] of experience in a healthcare setting.

Meanwhile, IT folks without healthcare experience will continue to create great new UI and UX stuff everywhere else.