Why electronic medical records are falling short


Yesterday we talked about how electronic medical records were not living up to their promised advantages over paper records. Today we delve further into why EMRs aren’t yet working the way they were intended. One of the biggest problems is that doctors tend to use pen and paper workarounds with EMRs, and other computerized communication breakdowns also cause problems with the adoption of EMRs in doctors’ offices and hospitals.

An instance where EMRs could really improve patient care is during patient referrals. A primary care physician may need to refer a patient to a specialist for further testing and diagnosis. If EMRs worked the way they should, then doctors could avoid a lot of phone calls and faxes while getting the patient’s information sent to and from the specialist’s office. In theory, EMRs should improve legibility of patient data, decrease the likelihood of misplaced information, and give physicians reminders that prompt the next action to take for a patient. The patient’s data could be accessed in real time as test results and diagnoses are entered. Unfortunately, pen and paper workarounds and communication breakdowns are creating flaws in EMR systems.

For example, unless a specialist indicates in the EMR system that a primary care physician should receive a notification or alert, then the PCP may not know when a patient’s test results are available. The specialist may even write their findings on a piece of paper that may or may not be entered into the EMR system, which creates gaps in patient documentation. Or if these notes are entered by a medical staff member other than the physician, it can produce unverified medical records. Another workaround that has often been seen in doctor’s offices is the use of shadow processes which providers use when they believe that the EMR system is not giving them the functionality they need, such as using spreadsheets which provide more data entry flexibility.

It’s a shame the EMR systems seem to be reducing contact instead of improving contact between physicians. Fortunately though, studying the types of workarounds and communication breakdowns that are already cropping up in the use of EMRs can give system developers valuable insight into how EMRs can be improved. (Via Healthcare IT News)

(Picture via Social and Technological Action Research Group)

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