{"id":8381,"date":"2017-05-14T17:04:56","date_gmt":"2017-05-14T21:04:56","guid":{"rendered":"http:\/\/blogs.nejm.org\/hiv-id-observations\/?p=8381"},"modified":"2017-05-17T11:20:18","modified_gmt":"2017-05-17T15:20:18","slug":"poll-feature-electronic-health-records-important-patient-care","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/poll-feature-electronic-health-records-important-patient-care\/2017\/05\/14\/","title":{"rendered":"Poll: Which Feature of Electronic Health Records is Most Important to Patient Care?"},"content":{"rendered":"

\"\"<\/a>The first electronic medical\u00a0record I used regularly — called “BICS” — initially had\u00a0one<\/em>\u00a0purpose. It was a tool to look up a patient’s lab results.<\/p>\n

Simple, reliable, and blazingly fast, it\u00a0did one thing remarkably well.<\/p>\n

Later, one of our Emergency Department doctors, who happens to have impressive coding skills, worked with a team to add a simple\u00a0ambulatory medical record (medications, allergies, a problem list, progress notes).<\/p>\n

Soon after, they released an astonishingly\u00a0efficient inpatient order entry system, one that relied on\u00a0keyboard shortcuts. Use of\u00a0the mouse was definitely for amateurs.<\/p>\n

After a brief learning period that took the interns around a nanosecond, all the clinicians\u00a0loved it. It\u00a0was so popular that the medical housestaff even held\u00a0a party in its honor, something they called “OlymBICS,” with teams competing to see who could enter orders the fastest.<\/p>\n

Much of its success, I’d argue, had to do with the simplicity — it didn’t overreach. Today, of course, all the big\u00a0EHRs\u00a0(or EMRs, or whatever you want to call them) try to do all things for all people — doctors, nurses, patients, administrative staff. I wouldn’t be surprised if there are features for the hospital cafeteria and catering services.<\/p>\n

And because the range of these\u00a0activities is so broad, EHRs\u00a0have\u00a0become bloated, complex, and inefficient. The complexity steals\u00a0attention away from our patients as we try to satisfy\u00a0the insatiable screen, keyboard, and mouse.<\/p>\n

There’s just so much to do (and so many opportunities to do it wrong), it’s hard to concentrate.<\/p>\n

In a piece called “Death By A Thousand Clicks,”<\/a> some local colleagues write the following:<\/p>\n

It happens every day, in exam rooms across the country, something that would have been unthinkable 20 years ago: Doctors and nurses turn away from their patients and focus their attention elsewhere \u2014 on their computer screens … EMRs have become the bane of doctors and nurses everywhere. They are the medical equivalent of texting while driving, sucking the soul out of the practice of medicine while failing to improve care.<\/p>\n

Yes, we all\u00a0recognize that feeling!<\/p>\n

These problems notwithstanding, it’s clear that\u00a0not even the crankiest EHR\u00a0critic\u00a0would propose that we go back to the days of paper charts, radiology film libraries, or having to call the lab to get patient test results.<\/p>\n

Part of what makes the problems with EHRs so frustrating is that there is so much potential for excellent, intuitive, and interoperative systems. EHRs already do some things very well indeed.<\/p>\n

The British struggled when their EHRs went down in the recent WannaCry cyberattack<\/a>, and not just because they were still using an unpatched version of Windows XP.<\/p>\n

(XP? Seriously? Yikes.)<\/p>\n

So to detail the\u00a0EHR benefits, and in honor of BICS (may it R.I.P.<\/a>), I list below several widely available EMR functions.<\/p>\n

You, dear reader, will choose the one feature you would miss the most during patient care if it\u00a0suddenly were no longer available. In the comments section, feel free to elaborate why you chose what you did.<\/p>\n

And I’m pretty sure I can predict the loser of\u00a0this poll.<\/p>\n

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What function of electronic medical records would you miss most if it were unavailable?<\/strong><\/p>

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  • View Results<\/a><\/p><\/div>\n\t<\/form>\n<\/div>\n\n

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