“Searching thru an EMR is Like Playing the Game, Where’s Waldo?”
That’s how one doctor describes the typical search for relevant information in an electronic medical record (EMR). Whereas a prenatal (paper) chart may be six pages in length, the comparable electronic version can stretch on for 20 pages, full of checkboxes, indecipherable billing codes, irrelevant questions, etc.
What’s more, electronic records in many instances were designed with insurers’ needs in mind rather than other physicians.
EMRs have been over hyped. They only work well when they are adopted by the people who are supposed to use them. They don’t work well when they are imposed on people by others.
EMRs are like environmetalism. For a lot of people they have become a new religion.
Is it me or can anything that is capable of being written on a notecard also capable of being typed into a computer?
I can see why checking millions of boxes that don’t apply to the patient could easily make the chart hundreds of pages long and contain no useful information.
But if doctors and nurses can write “Saw patient at 10 am, gave him some medicime.” on a chart, then why can’t they type it into a computer? You at least save the handwriting problem. And you can email it easily.
At its core, an EMR is essentially nothing more than a database of patient information (so is a shoebox full of receipts, which could technically be described as a database of business expenses – although not a very good one).
To make a database user-friendly, it needs report interfaces that pull selected information from the database and displays it in condensed, easy-to-read form. Each report should be specifically tailored to needs of many different types of users.
It sounds as though many EMR designers have yet to figure out what doctors need to know quickly and have the EMR generate a report for that. Input screens, used to collect data, are not the screens a doctor needs to see when pulling useful information from the EMR. The report that displays what a doctor needs to know should be designed by doctors with doctors in mind. Not designed by programmers with no knowledge of how doctors interact with patients.
Virginia,
EMRs aren’t necessarily about patient care. Since the data needs to be searchable by everyone on the “care team,” billing groups, quality control types (drug interaction warnings, advice and so on flow from this), and researchers, people using them are forced to enter data that may or may not be relevant in specific ways that may or not be useful to a particular physician at any given time.
Data entry via computer may also take more time. The question is whether the ability to email and other efficiencies outweigh the costs from the changes in workflow that EMRs create.