The split, as described by Drs. Saldaña and Ator, is that EMR users have lined up in proverbial camps. “For some people, they don’t see any way out,” Dr. Saldaña said. “And other people have a lot of hope; they’ve learned to master the tool to [fit into] their work flows, and they thrive. Then, there are a lot who struggle. It’s probably a bell curve of physicians. The great majority fall in the middle.”
Explore this issue:December 2018
The core concept in informatics is that a computer plus a person is better than the person alone … assuming that’s all done right, the computer can be, not an intrusive thing, but something that helps the doctor be better. —Gregory Ator, MD
Teaching the Future
Laura Fitzmaurice, MD, a pediatrician and CMIO at the University of Missouri-Kansas City School of Medicine, said that things are better now than when EMRs first appeared on the scene. Part of the reason they have a bad reputation is that studies and anecdotal evidence on their efficacy lag the technology, she said. “There have been a lot of advances, but I feel like sometimes in the literature, we’re behind,” added Dr. Fitzmaurice. “Stuff out there is from maybe a few years ago, [and] advances are happening so quickly.”
In large part, those advances arise from the fact that CMIOs across the country are working to ensure that rank-and-file physicians don’t give up on technology. “In the beginning, it was trying to get people up on EMR,” Dr. Fitzmaurice said. “Now, it’s about, ‘What do we need to improve your experience? How can we do more for your workflow?’ We’re using science from human factors, interactions. We’re using LEAN process improvement. Technology project management that’s with LEAN. Trying to just keep working through.”
Dr. Saldaña agreed that working with all stakeholders is important all the time, not just when choosing a vendor up front. “When we implemented the electronic health record, we didn’t just say we’re turning it on, and that’s it,” he said. “It was, we’re going to partner with you to try to continue to make it better. And that’s a commitment.”
Dr. Ator said he is working on future research to help better identify different types of EMR users. By being able to understand the types of users, EMRs can take the next step in being more useful to them, he added.