The session on EMRs was quite interesting today, it was both validating. frustrating and terrifying to have the concerns I had acknowledged and then to learn so many concerns. So much time, money and energy spent on a system that is just not effective at doing what we need it to do. What is also frustrating to me is that not only is this system not doing what we need it to do, but it is also pulling us away from the bedside and plopping us into dictation rooms and work stations. As Dr. Verghese once described, we are taking care of “iPatients” and “chartomas.” Getting further away from the patient and deeper behind the screens makes us more prone to errors, as we are spending less time taking care of the patient at the bedside and more time taking care of the chart. We aren’t building the relationships with the families and nurses and communicating and collaborating. In fact, a lot of communication seems to be with the help desk.
In addition to this being dangerous, this practice of medicine is also just less fun and engaging. I don’t to sit and wrestle with the problem list trying to find the right ICD code or figure out in what special section I need to click some obscure box. I want to sit with my patients, listen to them, communicate with them and do a physical exam that is engaging, interesting and triggers all of the feelings inside of me that brought me to medicine in the first place. While I acknowledge the benifits of the EMR, so often it seems to get in the way of me really seeing my patients, litterally.
Abraham Verghese, M.D.
N Engl J Med 2008; 359:2748-2751
December 25, 2008