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Chronicles

The story behind the story

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Report: US has spent $36B digitizing health records, which has risked patient safety with thousands of reports of deaths and injuries tied to software glitches

The U.S. government claimed that turning American medical charts into electronic records would make health care better, safer, and cheaper. Tweets: @erictopol , @ldrogen , @seemacms , @laware75 , @rosenthalhealth , @sarahkliff , and @nbsaphiermd Tweets: Eric Topol / @erictopol : One of the best pieces written on the abject failure of #EHRs http://khn.org/... @KHNews @FortuneMagazine by @FredSchulte @erikafry —dedicated to billing, business of medicine —the case for patients owning their medical data —doctors as data clerks en route to burnout http://twitter.com/... Leigh Drogen / @ldrogen : $36B!!! What tech company has a $36B R&D budget? My god just let google do it. http://twitter.com/... @seemacms : The below article shares the findings of a joint investigation by @FortuneMagazine & @KHNews on the impact of a messy EHR system. Take a moment to read through to better understand EHRs w/in our #healthcare system, & the direct impact it could have on you: http://fortune.com/... Liantawa / @laware75 : “Many doctors say they spend half their day or more clicking pulldown menus and typing rather than interacting with patients. An emergency room doctor can be saddled with making up to 4,000 mouse clicks per shift.” http://twitter.com/... Elisabeth Rosenthal / @rosenthalhealth : $36 billion in taxpayer money. Poorly spent? When innovation in health care proves better for profits than patients. Deep dive from @KHNews and @FortuneMagazine @FredSchulte @erikafry http://khn.org/... Sarah Kliff / @sarahkliff : I have been waiting for someone to investigate the mess of American electronic health records, and this big new piece from @KHNews does not disappoint. http://khn.org/... Nicole Saphier / @nbsaphiermd : The U.S. government claimed that turning American medical charts into electronic records would make #healthcare better, safer, and cheaper. Ten years and $36 billion later, the system is an unholy mess. @KHNews #EMR @AAPSonline http://khn.org/...

Kaiser Health News

Context & Ripple Effects

The $36B federal push to digitize American medical charts was sold on making care safer and cheaper, but the groundwork for today's findings was laid years earlier: by 2015 reporters were documenting how lack of interoperability among vendors like Epic still hampered data exchange for doctors despite the billions spent.

The arc since then has been one of disillusionment — a 2018 New Yorker piece argued computerization largely failed to simplify work in healthcare, leaving many doctors hating their PCs — while Epic quietly consolidated the market, with profiles noting it holds records for more than half of US patients. The Kaiser Health News/Fortune investigation now adds the gravest charge yet: the software itself is implicated in thousands of reports of deaths and injuries.

First-order effects

  • Hospitals running EHR systems from dominant vendors like Epic face immediate pressure to audit, patch, and report software glitches now tied to patient deaths and injuries, rather than treating them as routine IT issues.
  • Eric Topol and other prominent clinician-commenters amplifying the investigation sharpen a public narrative that EHRs serve billing and the business of medicine, not patients — direct reputational exposure for the vendors.

Second-order effects

  • Because Epic alone claims records for more than half of US patients, its market concentration turns every systemic defect into an industry-wide safety event, strengthening the case for rules that open access to patient records — a fight in which Epic has since urged large hospitals to oppose proposed data-access rules.
  • Hospitals and buyers gain leverage to demand usability and safety accountability in contracts, shifting procurement conversations away from feature checklists toward error rates and clinician workload — the burnout cost Topol highlights.

Third-order effects

  • If the pattern holds, federal digitization incentives evolve from paying for adoption to conditioning payment on demonstrated safety and interoperability, forcing consolidation-era vendors like Epic to compete on outcomes rather than lock-in.
  • The investigation feeds a broader rethinking of who controls medical data, with patient ownership proposals gaining ground against a vendor-dominated record system built around billing.

The trend: Healthcare digitization is pivoting from a decades-long adoption-at-any-cost buildout toward accountability for software safety, clinician burden, and patient control of records.