Who Moved My Cheese (or Paper Charts)?

I got just a glimpse yesterday of what clinicians must feel like when they log into an EMR for the first time – giddy with anticipation, hopeful that its use will ultimately lead to better patient outcomes and easier workflows for all. On the flipside, there was also frustration, impatience, and a bit of confusion.

Just before bedtime, I fired up Calorie Counter, my newest iPad app. As with any community you join, I first had to fill out a member profile, which took some time. I then had to learn through trial and error how to navigate through the program – search for, find and choose the foods I had eaten earlier that day, make adjustments for portion sizes, then log the data. The app’s drop-down menus included some of the foods I ate, but not all. “How do I add foods to the stock menu?” I wondered, thinking at the same time that this must be what doctors feel like when they can’t find what they need in an EMR.

It didn’t take long, and I’m sure now that I’ve at least done it once, future data entry will be more intuitive, and quicker. I do wonder about the rate of retention for this type of app, though. Do people stick with it for more than a few days or weeks?

I’ll have to either keep a running paper list of the foods I eat throughout the day, or bring my iPad with me wherever I go in order to log my calories. I was bummed that I couldn’t find this particular app for both the iPad and iPhone. (Those that were developed for both just didn’t seem to be as robust.) Perhaps this twinge of disappointment has been felt by doctors who have fallen in love with their new EMR, only to realize they can’t access it via their chosen mobile device.

It will take dedication on my part to keep up with daily logging of calories and activity, but I am convinced it will be worth it. After just one day, I’ve already had a nutritional wake-up call: Just seeing how much cheese I eat has made me decide to cut back before bathing-suit weather.

The beauty of the app isn’t the comprehensive list of foods already plugged in from which to choose from, but the calorie recommendations it makes based on members’ profiles (weight/height/activity level/age/gender, etc.) and the analytics that will result after I have a few days/weeks/months logged. Patterns will emerge that will give me a clearer picture of my diet – foods I should keep eating, those I should eat in moderation, and those I should avoid all together as long as I’m trying to reach a certain daily caloric intake. Not quite as important, but still similar in my mind to the aggregating power EMRs have when it comes to clinical data.

Other than keeping up with the daily log, I also have the option of joining the Calorie Counter community on Facebook, and I think there’s a brief tutorial out there I can take a look at. Depending on my time available, I may not do either – a course of action I’m sure a few doctors also opt to take with their EMRs, which I assume is ultimately detrimental to the results they’ll see with the technology.

In addition to trying to get a bit healthier, I’m overcoming my resistance to change (as if I really want to eat less cheese!), which as my colleague John pointed out in a recent post at EMRandHIPAA.com, is “the number one reason doctors aren’t adopting EHR software.”

But change is usually good, and as John also points out, “resistance to change is going to be the reason why EHR adoption will become the norm.” I’ll let you click over to his post to find out why. In the meantime, I’m going to try and resist the bagel with cream cheese that seems to be calling my name from the kitchen.