Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

What are the biggest issues with EMR today?

Kevin R. Campbell, MD
Tech
November 19, 2012
Share
Tweet
Share

As medicine moves forward in its most technologically advanced era yet, we continue to struggle with basic concepts such as record keeping.  The medical record is vital to the care of the patient.  It tells the story of each patient’s journey through the medical system.  The idea of centralizing all pertinent medical information is, in theory, a step in the right direction.  In utopia, there would be one medical record for each and every patient that could be accessed by any healthcare provider on the planet at a moments notice.  However, in practice, this is a monumental task.  The New York Times published as special section on The Digital Physician.  As part of the feature, the current state of the electronic medical record (EMR) was examined.

The Federal government has mandated the implementation of EMR in order for providers to be paid at the highest allowable rates and receive certain incentive pay for complying with EMR. Terms such as “meaningful use” have been coined by legislators in Washington, DC.  Certainly, a great deal of money has been spent by both the US government as well as individual providers to develop EMR and implement electronic records by predetermined government deadlines.  EMR has the potential to provide increased patient safety and significant cost savings if developed properly.  However, current EMR systems are not really ready for “prime time”  There is no real data out there that has demonstrated improved outcomes with EMR use–it is interesting that Medicare refuses to reimburse for unproven therapies but the Federal government will mandate EMR implementation without long term outcomes data.  Only recently are studies emerging to give us some idea of the impact of EMR on patient outcomes.  I think that there is a great deal of work to be done in order for EMR to have the desired impacts on safety, communication and healthcare cost containment.

What are the biggest issues with EMR today?

1. Work flow.  Many providers find EMR to decrease efficiency and decrease patient thru-put due to non user friendly interfaces and difficult navigation.  Many physicians find that the EMR actually adds significant hours to their work day.  From personal experience, it is often that I am in the office after hours completing EMR notes.  Sometimes I have to finish them at home on the weekends.  Proponents of EMR argue that electronic records streamline and  reduce physician time spent with documentation.  Nothing could be farther from the truth.  Many EMR systems are cumbersome and time consuming.

2. Errors in documentation. Most EMRs are plagued by erroneous data.  As my wife ( a lifelong outcomes researcher) often says about databases in general–”garbage in equals garbage out”.  The point and click and drop-down menu capabilities of most EMR systems foster the propagation of erroneous data.  Unless a provider takes the time to audit the electronic record on each visit, inaccurate information can be placed in a record and continued forward.  In addition, auto-populate and recall functions can lead to documentation of things that were never done (such as particular physical exam components).

3. Interruption of the doctor-patient relationship.  As I have mentioned in a previous blog, we must take great care not to allow the computer to come between doctor and patient.  We must continue to practice the art of medicine which requires that we actually talk and listen to our patients. We must not forget the value of interacting with patients, looking them in the eye, and providing them undivided attention.  Computers, laptops, and iPads in exam rooms foster distractions–I make it a point to leave my laptop at the workstation and put my notes in the EMR after the patient has left the exam room.  This often leads to finishing notes after hours.

The future

The EMR has an important place in the practice of medicine going forward.  However, I believe that we are rushing forward, blindly running to implement flawed systems in order to meet arbitrary government deadlines.  I believe that we must take a step back, evaluate the good, the bad and the ugly about EMR.  Only then can we work to craft a system that will accomplish what everyone in medicine wants–more efficient patient care, improved outcomes, increased patient safety. 

Kevin R. Campbell is a cardiac electrophysiologist who blogs at his self-titled site, Dr. Kevin R. Campbell, MD.

Prev

5 steps to establish a partnership for shared diagnosis

November 18, 2012 Kevin 0
…
Next

Good decision making often depends on good communication

November 19, 2012 Kevin 2
…

Tagged as: Health IT, Primary Care

Post navigation

< Previous Post
5 steps to establish a partnership for shared diagnosis
Next Post >
Good decision making often depends on good communication

ADVERTISEMENT

More by Kevin R. Campbell, MD

  • Is there a PBM mafia?

    Kevin R. Campbell, MD
  • This South Pacific island will change how you think about health care

    Kevin R. Campbell, MD
  • How Twitter is a vital tool in medicine

    Kevin R. Campbell, MD

More in Tech

  • Would The Pitts’ Dr. Robby Robinavitch welcome a new colleague? Yes. Especially if their initials were AI.

    Gabe Jones, MBA
  • Generative AI 2025: a 20-minute cheat sheet for busy clinicians

    Harvey Castro, MD, MBA
  • Why public health must be included in AI development

    Laura E. Scudiere, RN, MPH
  • Here’s what providers really need in a modern EHR

    Laura Kohlhagen, MD, MBA
  • AI and humanity in health care: Preserving what makes us human

    Harvey Castro, MD, MBA
  • AI is not a threat to radiologists. It’s a distraction from what truly matters in medicine.

    Fardad Behzadi, MD
  • Most Popular

  • Past Week

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • How community paramedicine impacts Indigenous elders

      Noah Weinberg | Conditions
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
    • A physician’s reflection on love, loss, and finding meaning in grief [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • How medical culture hides burnout in plain sight

      Marco Benítez | Conditions
  • Recent Posts

    • A physician’s reflection on love, loss, and finding meaning in grief [PODCAST]

      The Podcast by KevinMD | Podcast
    • How fragmented records and poor tracking degrade patient outcomes

      Michael R. McGuire | Policy
    • How New Mexico became a malpractice lawsuit hotspot

      Patrick Hudson, MD | Physician
    • How I learned to stop worrying and love AI

      Rajeev Dutta | Education
    • Understanding depression beyond biology: the power of therapy and meaning

      Maire Daugharty, MD | Conditions
    • Why compassion—not credentials—defines great doctors

      Dr. Saad S. Alshohaib | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 12 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • How community paramedicine impacts Indigenous elders

      Noah Weinberg | Conditions
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
    • A physician’s reflection on love, loss, and finding meaning in grief [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • How medical culture hides burnout in plain sight

      Marco Benítez | Conditions
  • Recent Posts

    • A physician’s reflection on love, loss, and finding meaning in grief [PODCAST]

      The Podcast by KevinMD | Podcast
    • How fragmented records and poor tracking degrade patient outcomes

      Michael R. McGuire | Policy
    • How New Mexico became a malpractice lawsuit hotspot

      Patrick Hudson, MD | Physician
    • How I learned to stop worrying and love AI

      Rajeev Dutta | Education
    • Understanding depression beyond biology: the power of therapy and meaning

      Maire Daugharty, MD | Conditions
    • Why compassion—not credentials—defines great doctors

      Dr. Saad S. Alshohaib | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

What are the biggest issues with EMR today?
12 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...