Provocative piece by hospitalist el jefe Bob Wachter. He laments how archaic most electronic records are, and I agree:
You’d think that medicine’s conversion from paper to electronic records would solve many of these problems, but ““ to date ““ all it has done is create new-fangled electronic silos. In most EMRs, including the GE system we’re using at UCSF, the notes are really just electronic incarnations of what previously lived on dead trees ““ no more likely to facilitate collaboration than the paper records they replace.
In many cases, they spew out template-driven notes that are long on noise and contain very little useful information. Very little power of the electronic medium is being harnessed.
On the other hand, Web 2.0 sites, like Facebook, provide intuitive tools that enhance collaboration and social communication:
How great would it be if, through the medical record, I could interact with multiple specialists who have seen my patient ““ in real time, just like my kids are interacting with far-flung friends on Facebook. And if nurses could leave me a note which I could answer online without having to respond to a page. And if the daily plan for a patient ““ developed collaboratively ““ could be shared among all the caregivers, with notes appended when a patient’s clinical ship seemed to be blowing off course.
One problem is that much of health information technology is staffed and programmed by has-beens. There is very little innovation, with most of forward-thinking ideas confined to sites like Google, Facebook, and MySpace.
It would be nice if an electronic record was designed with the singular focus being the end-user experience. They should make physician’s lives immeasurably easier, and significantly decrease the time spent charting and tracking patients.
There are very few record systems that meet even this minimal standard.
An EMR like Facebook? We can only wish.
