Your EHR Was Designed for Billing, Not for You

In 2009, the federal government paid hospitals and clinics $27 billion to adopt electronic health records. There was one problem: the spec was written by administrators, not doctors.

The result is the software you use today. It's great at generating claims. It's great at checking compliance boxes. It's great at making sure every field is filled in so someone, somewhere, can get paid.

It is not great at helping you take care of people.

You already know this. You know it every time you click through 14 screens to document a follow-up. Every time you copy-paste your own note because the template is worse than starting from scratch. Every time you chart at 10pm because the software didn't save you time — it created work.

How we got here

The HITECH Act meant well. Paper records were a mess. Digitizing them was the right call. But "meaningful use" requirements turned EHRs into audit trails with a medical degree. Vendors optimized for certification, not for the person actually using the software.

And it worked — for the vendors. Epic is worth an estimated $45 billion. Clinicians, meanwhile, spend two hours on their EHR for every one hour with patients. That's not a stat from some think piece. That's what researchers found when they actually measured it, in a study published in the Annals of Internal Medicine.

The lock-in part

Here's what really stings: you can't leave. Your patient data sits in a proprietary format behind an export process that's technically possible and practically miserable. So you stay. You adapt. You hire a scribe or work weekends. You accept that this is just what practicing medicine feels like now.

It isn't. Or at least, it shouldn't be.

Software should work like you think

A medical record doesn't need 47 tabs. It needs to show you what matters about this patient, right now, in the way you think about it. The rest — coding, follow-ups, referral letters — should happen in the background, done by the system, reviewed by you.

That's not futuristic. That's just good software. The reason it doesn't exist yet isn't technical. It's because nobody with the right tools has bothered to build it for a solo practice with 200 patients instead of a health system with 200,000.

We're building it now.