Paper medical records can easily go missing, contain bad or missing information and undermine patient care. But consider the alternative, says Alexander Friedman, a fellow in maternal-fetal medicine at the University of Pennsylvania.
As a resident fresh out of medical school, Friedman was working an an ememrgency room switching over to electronic medical records, he writes in a guest column on WSJ.com. Checking boxes and inserting codes required by the new system became the focus rather than tending to the patient, he says. As a result, he adds:
I often stood turned away, typing on the computer mounted against the wall, occasionally turning my head over my shoulder to make eye contact. I used a pre-emptive apology — “I’m sorry. I apologize for having my back to you” — but knew the excuses didn’t make up for the rudeness. A patient in pain or worried about her pregnancy deserves attention.
Friedman says EMRs are designed to communicate with insurers, not for care providers to communicate with each other. At the same time, he notes the success of the Veterans Administration’s electronic system in producing dramatic care improvements, as cited in a 2003 NEJM study.
But he sees the VA’s broad effort to apply electronics for improving accountability, integrating services and improving patient safety as an exception to how most systems are designed. “If electronic records are only used to optimize billing and improve chart audits, patients will see little benefit,” he says.
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