Two years ago, when I began a fellowship at a very large university, I quickly had to learn the ins, outs and peculiarities of three different EHR systems, none of which were remotely efficient, intuitive or compatible.
A few months ago, while the dreaded disease was a hot media topic and seemingly on every broadcast, I heard that EHRs were partially to blame for poor communication between a nurse and physician caring for Ebola patients. I briefly, quietly hoped that this incident might generate some outcry and create enough public attention to allow the return of paper medical records.
No such luck.
Nevertheless, the Ebola EHR story illustrated the idea that old-fashioned verbal communication remains critical, and EHRs may be so inherently complex that instead of allowing better access to information they promote the opposite.
Poorly Organized; Difficult to Access
In my experience, the electronically stored EHR information is too often poorly organized and difficult to access.
For example, the two EHRs with which I had to cope during my fellowship bore the same name and were from the same vendor, but, despite all the goodies, they did not talk to one another.
As a medical trainee, you quickly become paranoid when learning the new computer system may take more time than caring for the patient. But you have no choice, and—one way or the other—after hours of otherwise productive time, you learn to deal with it to the extent that you may finish your documentation before your next shift starts or the day ends.
I dream of an EHR that might allow me to treat a patient while looking them in the eye instead of into the sightless eye of the computer screen.
One can spend time tweaking the program to create templates, or so-called “favorites,” in an attempt to ease the use of these products—in theory, the EHR vendor’s job.
The vendors arguably have some of the world’s most educated and intelligent consumers (in no way including this author) providing them feedback and, by way of in-office modifications, improving their product for free, without a dent in the cost of the software. Picture this: You buy a sandwich from a fast food restaurant, and it does not meet your reasonable expectations, failing to perform at even an acceptable level of culinary mediocrity. So you wander back to the kitchen, don an apron, show them how you really want your food prepared and still pony up and pay the full bill before pulling out of the parking lot. In this respect, the predicament of the patron hungry for a fast, simple sandwich and the patron hungry for a simple, fast EHR are not dissimilar.
