An intriguing blog title, I know. I saw it on Bill Crounse, MD’s blog post and couldn’t resist extending the discussion. This is a really challenging topic and so it’s definitely worth of discussion.
On the one hand it’s clear to me that EHR software isn’t perfect. However, paper charts weren’t perfect either. On the other hand, people aren’t perfect either. Unfortunately, we don’t want to admit our imperfection and our society has gotten to the point that imperfections are unacceptable.
In the blog post mentioned above, Dr. Crounse offers the following suggestions and I’ll add my own commentary for each:
Involve the Patient Right from the Start – I’m hopeful that some of the companies working on this problem will get widespread adoption. The patient could definitely be more involved in entering their patient data before the visit even happens and thus relieve the burden on the clinician. This is a challenging problem to solve though when you consider the vast array of physician preferences.
Ease the Documentation Burden on Clinicians – This is mostly a knock on our current billing system. If we make the switch to value based reimbursement can we ease the documentation burden on clinicians? That’s worthy of its own post and some deeper thought. Sadly, I think in the short term it likely means more documentation burden for clinicians. I don’t see this happening soon, but it’s a noble goal.
Prohibit Templates, Cut and Paste – I generally disagree with this one. Ironically, the title of the post illustrates my issue with it, “Electronic Health Record solutions don’t make errors, people do.” It’s not templates and cut and paste that’s the problem as much as it is rushed physicians who don’t use it appropriately. I think one word describes most of the issues: laziness. I know. When I use a template for my blog posts or email blasts, I get lazy on them sometimes too. Fortunately, my blog posts or emails don’t have people’s lives hanging on them. So, maybe Dr. Crounse has a point. It’s just too easy to screw up templates and copy/paste.
Share Information with Patients – I’ve long been a proponent of the patient being aware of the information in the paper chart. I know that many doctors fear this. Usually they reference the fear that patients won’t understand the information that’s in the chart. I’ve just not seen this to be the case in practice and the benefits of the patient being able to be involved in their chart is so much more valuable than any perceived risk. The harder part is that I haven’t seen any system which creates a simple way for the patient to update/correct/verify information in a chart. Access is a great step forward, but the next steps is to empower the patient to assist in the patient chart quality control process.
As long as we have imperfect humans using imperfect EHR software, errors are going to happen. However, we can do better than we’re doing today. I like the ideas that Dr. Crounse suggested. I’d love to hear any ideas you have as well.