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

The sad state of EMRs: How they are doing more harm than good

Val Jones, MD
Tech
August 30, 2013
Share
Tweet
Share

I used to be a big believer in the transformative power of digital data in medicine. In fact, I devoted the past decade of my life to assisting the “movement” towards better record keeping and shared data. It seemed intuitive that breaking down the information silos in healthcare would be the first logical step in establishing price transparency, promoting evidence-based practices, and empowering patients to become more engaged in their care decisions. Unfortunately I was very wrong.

Having now worked with a multitude of electronic medical records systems at hospitals around the country, one thing is certain: they are doing more harm than good. I’m not sure that this will change “once we get the bugs out” because the fundamental flaw is that electronic medical records require data entry and intelligent curation of information, and that becomes an enormous time-suck for physicians. It forces us away from human interaction, thus reducing our patients’ chances of getting a correct diagnosis and sensible treatment plan.

How bad is it? The reality on the ground is that most hospitals are struggling enormously with EMR implementation. There are large gaps in the technology’s ability to handle information transfer, resulting in increased costs in the hundreds of millions of dollars per small hospital system, not to mention the tragically hilarious errors that are introduced into patient records at break neck pace.

At one hospital, the process for discharging a patient requires that the physician type all the discharge summary information into the EMR and then read it into a dictation system so that it can be transcribed by a team in India (cheaper than US transcription service) and returned to the hospital in another part of the EMR. The physician then needs to go into the new document and remove all the typos and errant formatting so that it resembles their original discharge summary note.

In one of my recent notes the Indian transcriptionist misheard my word for “hydrocephalus” and simply entered “syphilis” as the patient’s chief diagnosis. If I hadn’t caught the error with a thorough reading of my reformatted note, who knows how long this inaccurate diagnosis would have followed the poor patient throughout her lifetime of hospital care?

Another hospital has an entire wing of its main building devoted to an IT team. I accidentally discovered their “Star Trek” facility on my way to radiology. Situated in a dark room surrounded by enough flat panel monitors to put a national cable network to shame, about 40 young tech support engineers were furiously working to keep the EMR from crashing on a daily basis — an event which halts all order processing from the ER to the ICU. Ominous reports of the EMR’s instability were piped over the entire hospital PA system, warning staff when they could expect screen freezes and data entry blockages. Doctors and nurses scurried to enter their orders and complete documentation during pauses in the network overhaul. It was like a scene from a futuristic movie where humans are harnessed for work by a centralized computer nexus.

At yet another hospital, EMR-required data entry fields regularly interrupt patient throughput. For example, a patient could not be given their discharge prescriptions without the physician indicating (in the EMR) whether each of them is a tablet or a capsule. As patients and their family members stand by the nursing desk, eager to be discharged home, their physician is furiously reviewing their OTC laxative prescriptions trying to click the correct box so that the computer will allow the transfer of the entire prescription list to the designated pharmacy. When I asked about the insanity of this practice, a helpful IT hospital specialist explained that the “capsule vs tablet” field was required by Allscripts in order to meet interoperability requirements with our hospital’s EMR. This one field requirement probably resulted in hundreds of extra hours of physician time per day throughout the hospital system, without any enhancement in patient care or safety.

For those of you EMR evangelists in Washington, I’d encourage you to take a long, cold look at what’s happening to healthcare on the ground because of these digital data initiatives. My initial enthusiasm has turned to exasperation and near despondency as I spend my days as a copy editor for an Indian transcription service, trying to prevent patients from being labeled as syphilitics while worrying about whether or not the medicine they’re taking is classified as a tablet or a capsule in a system where I may not be able to enter any orders at all if the central tech command is fixing software instability in the Star Trek room.

Val Jones is founder and CEO, Better Health.

Prev

CT scans and radiation: How can patients limit risk?

August 30, 2013 Kevin 1
…
Next

In our efforts to be thorough, we are probably causing more harm

August 30, 2013 Kevin 5
…

Tagged as: Health IT, Hospital-Based Medicine

Post navigation

< Previous Post
CT scans and radiation: How can patients limit risk?
Next Post >
In our efforts to be thorough, we are probably causing more harm

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

More by Val Jones, MD

  • To solve the overmedication problem, follow the physiatrists

    Val Jones, MD
  • Interested in being a locum tenens physician? Read this first.

    Val Jones, MD
  • Why physicians should not complain about school debt

    Val Jones, MD

More in Tech

  • Bridging the digital divide: Addressing health inequities through home-based AI solutions

    Dr. Sreeram Mullankandy
  • Staying stone free with AI: How smart tech is revolutionizing kidney stone prevention

    Robert Chan, MD
  • Medical school admissions are racing toward an AI-driven disaster

    Newlyn Joseph, MD
  • AI in health care: the black box of prior authorization

    P. Dileep Kumar, MD, MBA
  • Hospitals are driving revenue and improving outcomes with telehealth

    Chris Gallagher, MD
  • How AI is revolutionizing health care through the lens of Alice in Wonderland

    Neil Anand, MD
  • Most Popular

  • Past Week

    • The hidden bias in how we treat chronic pain

      Richard A. Lawhern, PhD | Meds
    • Residency as rehearsal: the new pediatric hospitalist fellowship requirement scam

      Anonymous | Physician
    • The hidden impact of denials on health care systems

      Diana Ortiz, JD | Finance
    • Why no medical malpractice firm responded to my scientific protocol

      Howard Smith, MD | Physician
    • Misconceptions about food allergy safety in the skies [PODCAST]

      The Podcast by KevinMD | Podcast
    • C. Everett Koop’s defining stand against the tobacco industry [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Internal Medicine 2025: inspiration at the annual meeting

      American College of Physicians | Physician
    • Doctors don’t need yoga, they need time to smoke

      Salim Afshar, MD, DMD | Physician
    • What happened to real care in health care?

      Christopher H. Foster, PhD, MPA | Policy
    • The silent crisis hurting pain patients and their doctors

      Kayvan Haddadan, MD | Physician
    • How to build a culture where physicians feel valued [PODCAST]

      The Podcast by KevinMD | Podcast
    • Flatline: Our nation is dying, and we’re ignoring the signs

      Tomi Mitchell, MD | Physician
  • Recent Posts

    • Misconceptions about food allergy safety in the skies [PODCAST]

      The Podcast by KevinMD | Podcast
    • From rejection to resilience: my journey through emergency medicine residency

      Dr. Syed Hassan | Physician
    • Conflicts of interest are eroding trust in U.S. health agencies

      Martha Rosenberg | Policy
    • Why the words doctors use matter more than they think

      Erin Paterson | Conditions
    • What my first Match Day as a program director taught me about hope

      Ryan McCarthy, MD | Physician
    • Navigating the path from physician burnout to career balance [PODCAST]

      The Podcast by KevinMD | Podcast

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 31 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

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • The hidden bias in how we treat chronic pain

      Richard A. Lawhern, PhD | Meds
    • Residency as rehearsal: the new pediatric hospitalist fellowship requirement scam

      Anonymous | Physician
    • The hidden impact of denials on health care systems

      Diana Ortiz, JD | Finance
    • Why no medical malpractice firm responded to my scientific protocol

      Howard Smith, MD | Physician
    • Misconceptions about food allergy safety in the skies [PODCAST]

      The Podcast by KevinMD | Podcast
    • C. Everett Koop’s defining stand against the tobacco industry [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Internal Medicine 2025: inspiration at the annual meeting

      American College of Physicians | Physician
    • Doctors don’t need yoga, they need time to smoke

      Salim Afshar, MD, DMD | Physician
    • What happened to real care in health care?

      Christopher H. Foster, PhD, MPA | Policy
    • The silent crisis hurting pain patients and their doctors

      Kayvan Haddadan, MD | Physician
    • How to build a culture where physicians feel valued [PODCAST]

      The Podcast by KevinMD | Podcast
    • Flatline: Our nation is dying, and we’re ignoring the signs

      Tomi Mitchell, MD | Physician
  • Recent Posts

    • Misconceptions about food allergy safety in the skies [PODCAST]

      The Podcast by KevinMD | Podcast
    • From rejection to resilience: my journey through emergency medicine residency

      Dr. Syed Hassan | Physician
    • Conflicts of interest are eroding trust in U.S. health agencies

      Martha Rosenberg | Policy
    • Why the words doctors use matter more than they think

      Erin Paterson | Conditions
    • What my first Match Day as a program director taught me about hope

      Ryan McCarthy, MD | Physician
    • Navigating the path from physician burnout to career balance [PODCAST]

      The Podcast by KevinMD | Podcast

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

The sad state of EMRs: How they are doing more harm than good
31 comments

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

Loading Comments...