Look for similar articles under these categories: 

• EHR,
• Electronic Health Record,
• Electronic Medical Record,
• EMR,
• EMR Adoption,
• EMR Technology,
• Healthcare IT,
• Hospitals

3 responses to "One ED Doctor’s View on EHR: A “Certified Nightmare”"

1. # Brian commented on February 11th, 2012:

   Thank you for being willing to listen to someone who actually uses these things.

   Health IT news is such an echo chamber. I laugh and shudder every time there’s “white paper” about the amazing benefits of MediCompuTex3000 or whatever.

   In the trenches, this stuff pulls us away from our patients, gobbles precious mindshare, and is sometimes downright dangerous. And it’s not just click counts that are the problem. Every unintuitive click or unnecessary checkbox steals something away. It might be the way a pain was described, or the look I was given as I left the room, or the 6th critical thing I am remembering in a long list of critical things. But once I am clicking away, it is gone, to the detriment of my patients.

2. # John commented on February 11th, 2012:

   Brian,
   We do what we can to talk to as many providers as possible. I’ve been to conferences like AAFP with just that in mind.

   Your last paragraph intrigues me though. Couldn’t you just as easily lose something once you dive into a paper chart as starting to click away? I’m against “Certified Nightmare” EHR as much as the next, but some of the challenges you describe were and have been a problem on paper just as much as with an EHR. If done right, it could be less. If done wrong, then I can see your concern.

3. # Brian commented on February 14th, 2012:

   Your question is good, but the answer is definitely no. When I am ordering a non-contrast brain CT for a male patient on paper, I am not prompted to enter 1) whether the patient is allergic to contrast (which I am not ordering), 2) whether the patient is pregnant (duh?) 3) Whether the order should be for now or some time in the future, 4) whether it should be stat or routine, or 5) an indication from a list of indications, none of which remotely describes why I am ordering the scan.

   And there it goes–I had been reminding myself to go examine that unusual thigh bruise once I was done with this altered patient, and ask about recent travel etc… But now it’s gone. 5 clicks that didn’t need to happen and now my patient will never know she has Lyme disease.

   We physicians hold ourselves to very high standards and it is clear that EMR vendors hold themselves to “just good enough.”