Electronic medical records

The passage of the American Recovery and Reinvestment Act, spearheaded by Obama, required that healthcare providers adopt electronic medical records by January 1, 2014. Adoption was mandatory if providers wanted to maintain their existing Medicare and Medicare reimbursement levels.

Digital records were expected to improve accuracy, support clinical decision-making and make a patient’s records easily accessible to multiple providers and organizations. These benefits may have come to pass, but by now, most of us know that the technology has undermined face-to-face patient care. In their limited time with you, docs are looking at their screens, not at you. (Abraham Verghese calls this the “iPatient” phenomenon.)

Electronic medical records have also contributed to physician burnout. A report from the National Academy of Medicine revealed that, on an average, nurses and doctors spend 50 percent of their workday treating the screen, not the patient. A study of emergency room doctors revealed that putting information into the computer consumed more of their time than any other activity. A doctor needed to make six clicks of the computer mouse to order an aspirin, eight clicks to get a chest x-ray, 15 clicks to provide a prescription, and so forth. All in all, a ten-hour emergency room shift included 4,000 clicks of the mouse.

One solution is to hire medical scribes—people who enter patient information into the computer. The physician then reviews the notes, makes corrections, and signs off on them. Some scribes work remotely (I’m not sure how that works). Anyway, it’s estimated that in 2021, 100,000 scribes were working in medical practices around the country. In fact, medical scribing is the fastest growing healthcare profession in the nation.

In 2011, I had some experience dealing with electronic medical records. I was hired to write a user guide by one of the companies vying to get their product into the marketplace. I don’t think they succeeded. Their product was quite complex and rather unwieldy,  I still have my drafts and a few images. Here’s one I found:

Electronic medical records are here to stay, of course. I recently had my knees x-rayed at a radiology lab. When I showed up, all they asked for was my name and birthdate because all my info was in their system. Pretty nifty.

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