Every encounter I've ever had with EHR systems, whether direct or indirect, has been a complete mess. My online EHR through Kaiser is completely unusable, and according to the people who evaluate these things, it's supposed to be one of the best. [1]
Last week I was at the doctor twice, and both times the doctors were complaining about their EHR software, once because it takes so long to boot up, and the other time because it takes longer to sort through allergy testing results in digital form than it used to take with paper charts.
The problem is, the incentive structure in place forces docs to either adopt what's out there or miss out on big incentives, and eventually get penalized [2]. This creates a twisted incentive structure for software companies where they basically can capitalize on the fact that the docs have to adopt a system. All the software company has to do is put out something that's compliant with gov't standards, even if its totally unusable by doctors. Just take a look at the website of the company touted as a great example of the success of the gov't incentive program in the article: http://www.medfx.com/ Would this pass muster in the consumer internet space? In enterprise SAAS? Not a chance.
So the startups are incentivized to get something out so they can get in on the scheme before the window of opportunity closes, what about the big companies who have been building these systems for years? Well, they make most of their revenue from implementing, training, and maintaining systems, not from licensing software, so their incentives are to sell contracts, not make their software any better, because that ends up hurting their bottom line [3]. All they have to do is maintain relative parity with emerging companies, and get real, real good at sales.
It's really a shame, because there is enormous room for real innovation in this space. There is a truly incredible amount valuable data is siloed off in these systems, thats sometimes not even available to the physicians themselves [4] let alone researchers who could use the data. And that, of course, is not mention the potential to help doctors spend less time wrestling with charts, and more time caring for their patients.
[1] http://thesash.me/who-will-fix-the-ux-of-healthcare-a-3-tril...
[2] https://www.cms.gov/Regulations-and-Guidance/Legislation/EHR...
[3] http://thesash.me/who-will-fix-the-ux-of-healthcare-a-3-tril...
[4] My dad had to hire a consultant to make updates to his EHR system so that he could run queries for certain things among his own patients