Should Our Enthusiasm for EMRs Be Evidence-Based?
A 2005 study by University of Pennsylvania sociologist Ross Koppel surveyed doctors about a drug order system that the Hospital of the University of Pennsylvania had installed. He found 22 circumstances in which the software boosted the probability of error. The system would make doctors scroll through up to 20 screens to get a patient medication list; other times it would put multiple names on the same screen, making it easy to mix up patients. (Penn has replaced the software.) Many current systems in other hospitals "continue to have the same problems with thoughtless, sloppy user interfaces," Koppel says, including endless false-alarm alerts for minor drug interactions.
The answer is “yes.” It should be evidenced-based.
In US Oncology we are committed to going to a full EMR (nearly paperless), but it has been painful. Costs run about $70,000/ doc not counting lost productivity in the 6 month “learning curve”. After 6 months, the most computer efficient docs in our practice take 45 minutes per longer to do the same work as before the EMR. The average doc is closer to two hours per day. These later guys have to see fewer patients than before because there are no two extra hours in a twelve hour day. We believe that EMRs are necessary. However no one actually who uses them thinks they are more efficient or that they save money. If this guy says EMRs will help move us closer to a real market in medicine, I say “bring it on!”. …but I would like data that what these guys think in theory is true in practice. “In theory, there is no difference between theory and practice, but in practice there is.” Yogi Berra