In publications like this one, we spend a lot of time and energy clubbing EMRs and EMR vendors for the problems they cause. That’s all well and good, but it’s also worth remembering that some of the big problems surrounding medical operations may not be due to EMR use:
* HIPAA carelessness: When someone shouts private medical information across a room, or loses a flash drive or tablet with records on it, or leaves patient records in a public place, you’ve probably got a nasty HIPAA violation. But the EMR almost certainly had nothing to do with it.
* Clumsy office workflow: Sure, introducing an EMR into a clinical setting can screw up existing workflow. But was it working well in the first place? For those whose business falls apart post-EMR, I’d argue “no.” Businesses that don’t do well after an install had jury-rigged processes in place already, I’d argue.
* Patient care slowing down: As with staff workflow, clinical workflow can be discombobulated — badly — by an EMR installation. Learning to fit practice patterns to the system is a big job for most clinicians, and they may slow down significantly for a while. But if the patient care flow stays “broken” it’s likely that there were aspects of the pre-EMR system that didn’t work.
I realize that I might get flamed for saying this, but I’m pretty confident that a goodly number of problems that are laid at the feet of dysfunctional EMRs don’t belong there. And that’s not a good thing.
After all, there are enough poorly designed, trouble-ridden EMRs out there to keep us busy critiquing them for a century or two. Why distract ourselves by adding more to the pile when the real issues may be elsewhere?