Electronic health records and electronic prescribing: promise and pitfalls

Health information technology (health IT), especially technology related to electronic health records (EHRs) and electronic prescription (e-prescribing) systems, is believed to be the cornerstone for improvements in quality of care, patient safety, and efficiencies, all leading to cost benefits. With increasing requirements for quality reporting and with new pay-for-performance programs being initiated by insurers, many physicians are asking if it is time to invest in health IT. However, as those who have already made this decision have found, adopting EHRs and e-prescribing systems is not an easy task: Our colleagues resist their use, they are costly, the case for a return on investment for an ambulatory practice has not been well established, incentives to use are misaligned, implementations may be difficult, and often such systems disrupt or inhibit workflow.