This has been an interesting few weeks in my relationship with electronic medical records (EMR). I spent mandated training time for upgrading the EMR system and when I asked the trainer what benefit I might receive with the upgrade (hoping for more efficiency, a blend of clinic and hospital computer systems, less boxes to click etc.) I was informed that there would probably be no benefit for my practice. During the same time period, the hospitalists requested that I provide them with a short paper version of the order set for discharging patients with diabetes, as they are overwhelmed with the options and find the process incredibly time consuming. I spent time crafting a new series of “smart phrases” so that orders for correction doses can be specifically geared to the patient rather than generic doses that really don’t fit the patients’ individual needs which are embedded in the EMR. And in chatting with a friend who recently had surgery, her physicians hired a transcriptionist to fill in the boxes and write up notes. Voice recognition has replaced transcriptionists, and errors are not discovered until it is problematic and incredibly time consuming to correct.
I have to say, I am a bit disappointed in these multi-million dollar systems that are now required for our overstretched health care budgets, reducing efficiency and taking our minds, hearts and focus away from caring for our patients. The dream of having electronic medical records talk with each other, streamline the patient care system and most importantly, enhance the care of our patients at this time appears to be a failure in many aspects. Medical providers across the board (MD’s inpatient and outpatient, nurses, physical therapists and diabetes educators) are so focused on making sure all the boxes are checked, that patient care may truly be compromised.
Perhaps even more intriguing is the concept that we are helpless in this impersonal health care delivery system, discouraged to speak out and urged to ”just learn to accept it”.
In a few weeks, I leave for another medical mission trip to a third world country. We will be working with patients, listening, holding their hands, trying to understand how we can help. It will be refreshing to concentrate on the patients without paperwork, computers, and check off boxes. I hope we never completely lose sight of our mission to care for individuals, touch them and realize it really isn’t just about boxes. I am not against progress, and think there is some value in EMR – sharing of labs, drugs, and CAT scans, but I think we need to recognize the new challenges we are facing and not just put our heads in the sand. Have you found a personal, caring and efficient way to incorporate EMR into patient care? If so, please share your stories!