Electronic Health Records: An Awkward Third Wheel

Authors: Adam G. Golden, MD, MBA, Michael A. Silverman, MD, MPH, Thomas T. H. Wan, PhD, MHS


Despite the theoretical and anecdotal benefits of electronic health records (EHRs) that could bring improvements such as communication among healthcare professionals, a decrease in unnecessary testing, and lower healthcare costs, the definitive outcome studies have been inconclusive. Studies that review the pre- and postimplementation of the EHRs regarding expenses and quality of care may be limited by confounding factors because of concurrent care management and other transitional care system changes.Because of the variability among EHR systems and healthcare practices, improved outcomes in a research study may not generalize to other physicians and
medical facilities.

This content is limited to qualifying members.

Existing members, please login first

If you have an existing account please login now to access this article or view purchase options.

Purchase only this article ($25)

Create a free account, then purchase this article to download or access it online for 24 hours.

Purchase an SMJ online subscription ($75)

Create a free account, then purchase a subscription to get complete access to all articles for a full year.

Purchase a membership plan (fees vary)

Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.


1. Kaushal R. Reducing the costs of U.S. health care: the role of electronic health records. Ann Intern Med 2013;159:151-152.
2. Jones SS, Rudin RS, Perry T, et al. Health information technology: an updated systematic review with a focus on meaningful use. Ann Intern Med 2014;160:48-54.
3. Mangalmurti SS, Murtagh L, Mello MM. Medical malpractice liability in the age of electronic health records. N Engl J Med 2010;363:2060-2067.
4. O’Donnell HC, Kaushal R, Barron Y, et al. Physicians’ attitudes towards copy and pasting in electronic note writing. J Gen Intern Med 2009;24:63-68.
5. Sittig DF, Singh H. Electronic health records and national patient-safety goals. N Engl J Med 2012;367:1854-1860.
6. Cimino JJ. Improving the electronic health recordVare clinicians getting what they wished for? JAMA 2013;309:991-992.
7. Stetson PD, Bakken S, Wrenn JO, et al. Assessing electronic note quality using the physician documentation quality instrument (PDQI-9). Appl Clin Inform 2012;3:164-174.
8. Adler-Milstein J, Green CE, Bates DW. A survey analysis suggests that electronic health records will yield revenue gains for some practices and losses for many. Health Aff (Millwood) 2013;32:562-570.
9. Golden AG, Martin S, da Silva M, et al. Care management and the transition of older adults from a skilled nursing facility back into the community. Care Manag J 2011;12:54-59.