Are EMRs the Answer to Better Patient Care?

Do EMRs lead to better patient care? I’m on the side that says “no.”

In our offices, about 18 of them in our organization, we hand-write our progress notes, a system I didn’t think would work well when I had to give up dictation, but I’m now a believer. It’s impossible to write down everything the patient says, but that’s not the key to good patient care. Dr. William Osler said, “Listen to the patient, he will tell you what’s wrong with him.” My chief of cardiology at Tulane, George Burch, told us the same thing, adding “about 70% of the time.”

I went to my PCP last year for a physical and he didn’t lift his head once, just tapped on keys, responding to what I was saying… “Uh huh, yah, right, yes, ok… tap, tap, tap.” It’s bad enough that doctors are criticized for not talking with their patients, now we can add “not looking” at them, too. We don’t need boilerplate notes that don’t tell us anything about the patient or improve healthcare. We need specific information to stand out, and be able to find it when perusing our notes, or enable others to be able to find pertinent information when they need it.

I’ve read numerous disaster stories online about the drawbacks and shortcomings of EMRs. The costs are high and the rewards are small. HCPLive had a story about the Cleveland Clinic and its problems with EMRs. I’ve spoken to doctors at the University of South Florida Medical School in Tampa who told me that EMRs decrease productivity; fewer patients can be seen due to the time needed to learn and input data. I’m sure there are some specialties that can use EMRs effectively, maybe orthopedics, which is rather limited in scope (with all due respect to my orthopedic colleagues). I’d rather shmooze with my patients for a few minutes than keep my head down, while tapping my stylus on the computer, and lose that important aspect of communication.