Saturday, April 24, 2010

More on the Electronic Monster

We like to bicker about Electronic Medical Records here at Shrink Rap. They give Roy's life meaning. Clink and I are more ambivalent.

In An Unforeseen Complication of Electronic Medical Records, Dr. Paul Chen (NY Times, April 22nd) writes about trying to pay attention to the patient and the computer at the same time:

“EMRs are a phenomenal contribution to care,” said Dr. Ann S. O’Malley, lead author of the study and a senior researcher at the center. But there is often so much information available — some of which requires a direct and immediate response from the physician — that “some doctors liken the presence of EMR to having a 2-year-old in the exam room.”

As all parents can attest, while a 2-year-old can create chaos in any situation, a setting that is as delicately balanced as the clinical one runs the risk of falling into complete disarray. Doctors often must consider several issues simultaneously when seeing a single patient — all the potential diagnoses and possible treatments, the patient’s history and list of medications, any possible adverse effects or interactions, the limits of that patient’s health care coverage and numerous preventive health issues, to name just a few of those considerations. The addition of an electronic records system can push some doctors into what one EMR expert refers to as “cognitive overload.”

“The whole point of EMR is to simplify the process and to enhance and facilitate communication,” Dr. O’Malley said. “But in order for that to happen, EMR needs to be more user-friendly and more responsive to the clinical needs of patients and clinicians.”