Why Doctors Hate Electronic Medical Records

Unsent letter to the Tech Department:

So today I’m doing anesthesia for colonoscopies and upper GI scopes. Nowadays we have three board-certified anesthesiologists doing anesthesia for GI procedures every single day at my institution. I’ll probably do 8 cases today. I will sign into a computer or electronically sign something 32 times. I have to type my username and password into 3 different systems 24 times. I’m doing essentially the same thing with each case, but each case has to have the same information entered separately. I have to do these things, but my department also pays four full-time masters-level trained nurses to enter patient information and medical histories into the computer system, sometimes transcribed from a different computer system. Ironically, I will also generate about 50 pages of paper, since the computer record has to be printed out. Twice.

No wonder almost everyone I know hates electronic medical records! I don’t know anything about computers, and I don’t know what systems other hospitals have. I may be dreaming of a world that doesn’t exist or that world is here and I haven’t heard about it.

HT: Jason Shafrin.

Comments (11)

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  1. Smitty says:

    Electronic isn’t always better. Computers can be useful, especially if the proper training accompanies them!

  2. Studebaker says:

    I would hate them too if I had to sign on 32 times in one day!

  3. Sam says:

    Makes sense since it is not practical. Why isn’t the medical industry concerned in updating practical software that makes it actually easier to keep track of medical records?

  4. Ron says:

    Sign on 32 times a day? Well then how do you expect doctors to attribute efficiency to EHRs?

  5. Harley says:

    This will start to change as EHRs become more user friendly and a newer generation of doctors who are more tech savvy come in.

    That is of course assuming that we have a new generation of doctors. The shortages looming and all.

  6. Jack says:

    There are some systems which are more efficient. I wonder which system her hospital is using.

  7. Tiger says:

    Im sure the nurses love electronic systems. Doctors are known to have some of the worst handwriting around!

  8. Erik says:

    What a whiner, this guy needs grow up and do his job for heaven’s sake.

  9. Gabriel Odom says:

    A couple of things on this one:
    First off, endoscopy is THE most difficult “surgery” style charting in the entire EMR world. There is only 1 company that I’ve seen get it right, and thats endoPRO IQ from Pentax. The reason for this difficulty is the imaging software. Most EMRs can integrate ok with external images, but the cross-fuctionality is limited. endoPRO was designed from the ground up to be a photomedical documentation suite, which is exactly what is needed in any of the “-scopy” cases. The trouble is, endoPRO doesn’t always play nice with the other EMRs, and it can be very difficult to migrate data between multiple systems.

    Second, the complaint of “I have to put in my password so many thousands of times” is completely ridiculous. Whenever you write sign an order, you have to pick up a pen and physically sign a paper. In the electronic world, your password IS your electronic signature. So, I do not feel sorry for the doctors in this regard at all. This is their responsibility. However, this normal inconvenience is exacerbated by the multiple different EMRs – which is akin to making a doctor sign ALL forms in triplicate or quadruplicate.

    The third point ties into the second – many hospitals follow a “best of breed” EMR setup. This means that they have the best cardiology software, the best ICU software, the best billing, the best surgery scheduling, the best registration, the best materials management, the best everything. The catch? NONE OF THESE SOFTWARES TALK TO EACH OTHER. A nurse will log in to one suite to see and acknowledge the orders, another to release the orders in the Pyxis machine, and yet another to chart the medication on the MAR. This gets old really quickly.

    The cure for this is three-fold:
    1. Make better EMR software and software integration
    2. Educate the doctors and set expectations that this electronic documentation WILL NOT replace their charting – they will still have to do work.
    3. Have each hospital system on 1 interoperable patient medical record that follows the patient from outpatient to inpatient to billing and everywhere in between (take Epic for instance). This will also completely remove the necessity for printing 50 pages of paper twice per procedure.

    (Full disclosure: I am a former Epic employee who installed and maintained EMRs at multiple different hospitals. I did not get paid to speak well of the company or the software – I do it because I believe in it.)

  10. Glenn says:

    The concept of the EMR is good, but the implementation is often terrible. There is a constant disconnect between the developers and the end users. Apple had its smash success with tablet devices because Steve Jobs & Co focused hard on the human/software interface, and got it very right. With EMR’s, this is lacking. Mr. Jobs would probably have described every EMR in existence as “just sh*t!.” It seems that the money always runs out between purchase/installation of the EMR and implementation. Every installation could use a good programmer to streamline the integration of systems after they are installed, but that costs bucks and is never done well. Better yet, the “EMR” should be replaced by an integrated hardware/software device that is actually intended to make patient care easier and more streamlined, not just collect redundant data in electronic bits. Apple did a great job of this for the consumer, and the medical industry is just waiting for such an innovator to develop such a device to displace the clunky EMR’s we are currently burdened with.

  11. jsemj says:

    Perhaps you could be authenticated with some sort of NFC Utility?