Sadly, moving from your smartphone to your EHR is like traveling backward through time.
It’s no wonder that a Google search of the phrase EHR problems generates in excess of 3.8 million results.3 Why? Virtually all the products suffer from the same issues: poor visual displays, redundancy of layout and a major lack of interoperability with competitors’ products. It makes one pine for the days of the fountain pen and parchment!
As many of our fellows have remarked, it can be a daunting task to perform a thorough chart biopsy on those complicated patients with multiple medical issues and myriad medical providers. Where are the data buried? Wasn’t the ability to easily find critical data a crucial raison d’être for this whole exercise? Is there a solution to this chart bloviation, a quick and easy way to find those critical lab results and important physical exam findings in the mush of template-generated notes?
Fear not. A whole new industry has recently emerged, one devoted to finding those needles in your patient-record haystacks. Based on data mining technology, large troves of notes and lab results can now be readily scanned, akin to performing a Google search of your patient’s record.
Having spent in excess of $1.2 billion to convert its hospitals to the dominant system in EHR, Epic, my employer is now a major investor in one of these data mining systems.4 Perhaps this will allow them to recoup some of their anticipated loss of an additional $200 million from expenses tied to the implementation of Epic.5 Does the financial bleeding ever end?
Fear not, my fellow rheumatologists, about the recent guidelines allowing patients easier and quicker access to their personal records.6 In the past, some of us may have been concerned about patients perusing their records and spotting less-than-flattering characterizations of their personality or body habitus, or gasping at some embarrassing and sloppy typographical errors (see “Patient Access to Electronic Health Records Yields Unexpected Results,” The Rheumatologist, October 2014). Since the EHR encourages the use of note templates replete with medical prose that is often cloned into subsequent notes, they will observe how redundant and boring records have become. Just as our fellows toil at separating the wheat from the medical record chaff, so, too, do those eager patients seeking to discover our personal observations of them hidden somewhere deep inside their records.
Is Technology Too Good to Be True?
You may recall the story of Elizabeth Holmes, the Stanford University engineering dropout who at the age of 19 had the brilliant idea of creating a form of nanotechnology that would accurately and cheaply perform all sorts of laboratory tests by using just a few drops of blood (see “Can DIY Medicine Tame Rampaging Healthcare Costs?” The Rheumatologist, April 2015). An intense, highly focused and very disciplined woman, she pursued her dream with a visionary’s zeal, creating a startup company, Theranos, that achieved a valuation exceeding $9 billion.7
