Put a few otolaryngologists in a room together and each will likely have a story about how electronic medical record (EMR) systems have made life more difficult. Time away from the patient, they’ll say. Or hours spent on paperwork that could be used to build a practice, they’ll note. Money lost, they’ll grouse.
Explore this issue:December 2018
Everyone hates EMRs, right?
Well, not really, said Gregory Ator, MD, associate professor and director of the Division of Otology/Neurotology at University at Kansas Medical Center in Kansas City. Dr. Ator and colleagues recently surveyed approximately 500 providers in their medical system and, surprisingly, found that two-thirds have a positive view of EMR.
“One of the things I want to talk more about is, ‘What can a well-designed, well-implemented EMR do for the doctor?’” said Dr. Ator, who is also the chief medical informatics officer (CMIO) for the University of Kansas Health System. “I think that’s one of the things that we in this business have not thought about,” he added.
In fact, Dr. Ator thinks EMR has gotten a bad rap. To be sure, the fits and starts of nascent systems have caused myriad issues for otolaryngologists and other specialists. But as vendors have improved, systems have been upgraded. The promise of EMRs—more efficient workflow, improved patient care, even increased patient safety—is still worthwhile, Dr. Ator said.
“The core concept in informatics is that a computer plus a person is better than the person alone,” Dr. Ator said. “That’s really a fairly complex topic, because that includes concepts such as human-machine interface …[but] assuming that’s all done right, the computer can be, not an intrusive thing, but something that helps the doctor be better.”
Understanding the Past
Luis Saldaña, MD, chief medical information officer at Texas Health Resources of Arlington, Texas, acknowledged that the initial introduction of EMRs over the past decade has had issues.
Physicians wanted “this tool to help them be more compliant, but then it can easily become your master,” Dr. Saldaña said. “You go from it serving you to [you] serving it because, all of a sudden, the requirements and expectations just grow and grow.”
Those reporting requirements, especially to older physicians who spent decades writing “succinct, hand-written notes that effectively communicated what happened,” turned off many users, Dr. Saldaña added. “Now, even just the daily progress note, to fulfill the least-perceived regulatory requirements for being reimbursed … you have to create notes that are two full pages long,” he said. “We’ve created this kind of monster, and that whole journey kind of then led to this split.”