A terrific piece by Atul Gawande explores the issues related to adoption of EMRs (electronic medical records): Why Doctors Hate Their Computers

He reviews in-depth many of the reasons why doctors face difficulties with their EMRs:

• Spending twice as long in front of computer screen instead of with patients
• Longer days
• Endless problem lists
• Inability to delegate some tasks (that previously were done by staff) and needing to provide more information on orders

“Gregg Meyer … the chief clinical officer at Partners HealthCare, Meyer supervised the software upgrade.

‘We think of this as a system for us and it’s not,’ he said. ‘It is for the patients.’

While some sixty thousand staff members use the system, almost ten times as many patients log into it to look up their lab results, remind themselves of the medications they are supposed to take, read the office notes that their doctor wrote in order to better understand what they’ve been told. Today, patients are the fastest-growing user group for electronic medical records.”

Hospital systems can use EMRs in various ways:

• Arrange protocols for certain problems and these can be adjusted “far faster as new clinical evidence comes in.”
• Identify broad groups of problems. For example: EMRs can “identify people who have been on opioids for more than three months, in order to provide outreach and reduce the risk of overdose.”
• EMRs may help lower hospital mortality (after a transition period) Electronic Health Records Associated With Lower Hospital Mortality After Systems Have Time To Mature

Other topics:

• the emergence of scribes, including scribes in places like India where doctors transcribe recorded patient visits.
• physician burnout
• alarm/signal fatigue
• ” the inevitability of conflict between our network connections and our human connections.”

My take: This is a terrific article and shows why physicians are struggling with EMRs; this article explains the problem in a way that is easy for non-physicians to grasp.  It shows that other professions face similar challenges.

Related blog posts on EMRs:

• Aptly titled “The Cost of Technology” | gutsandgrowth
• Checklists for Crisis and Daily Care | gutsandgrowth
• Safety initiatives -the first 10 items | gutsandgrowth
• Reminders and Hard Stops for EMRs