A reader writes:

Electronic Health Records (EHR) have been touted as part of the solution to our expensive and inefficient system, but we shouldn't expect too much from it.  I am a nurse practitioner, and at my current job (in a large private internal medicine practice) we have used EHR for about seven years. 

It has improved care delivery in many ways – one is the reduction of medication errors due to illegible prescriptions.  But the system is cumbersome to use, even after all these years (and we have one of the best programs around, from what I understand).  It has, on average, added two more hours to my workday, and yet I am perpetually trying to catch up.  EHR is also incredibly expensive to set up and maintain, especially for smaller practices. Most importantly, different offices, hospitals, etc. use different software programs, and as a result we can't communicate with each other electronically.  We still get piles of paper faxes every day that have to be scanned into our system manually. 

EHR will eventually help our ailing system (especially as more facilities come on board), but in my opinion, the changes that would have the biggest impact would be (1) adopting evidence-based standards of care and (2) switching to a single-payer system. But I don't hold out much hope that either will occur during my career.