EHR Benefit – Legibility of Notes

Posted on December 12, 2012 I Written By

John Lynn is the Founder of the blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of and John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’ve hinted for a little while that I was going to start a series of posts talking about the various benefits of using an EHR. I think this is an important subject worth discussing in greater detail. I hope that this series of posts will also help us move past meaningful use of an EHR for the government EHR money and explore all the other reasons why healthcare should fully adopt an EHR.

Back when I first started blogging about EMR software (It was 2005, before the term EHR came to be), I made this list of EMR and EHR benefits over paper charts. I’ll be using that list as the starting point for this series of EHR Benefit posts. I love the first paragraph on that page (which I likely haven’t touched since 2005):

This list is just a starting point to list off all the possible benefits of having an EMR or EHR. Probably a poor one, but a start nonetheless. My plan is for this list to grow over time as I think of new benefits or as people suggest things I’ve most certainly missed. Also, I think that most people often focus too much on the financial benefits of an EMR and so hopefully this list will include financial and other benefits beyond the financial implications.

The list definitely did grow, but I guess I never got around to updating the intro paragraph. Although, I am pleased to see that even back in 2005 I was as interested in the non-financial benefits of EHR. Certainly the financial benefits of EHR are incredibly important, but far too many people don’t take into account the other non-financial benefits in their analysis of EHR benefits. It’s just too hard for many to try and compare or put a value on the non-financial benefits of EHR. We’ll try to point these benefits out just the same.

Now for the first EHR benefit on the list:

Legibility of Notes
I’m really glad to start with an EHR benefit that everyone can understand with little explanation. Poor medical handwriting has been a running challenge in healthcare for as long as we’ve been documenting patient visits. I did a quick search on Google for “write like a doctor” and it had about 321 million results. That’s quite pervasive.

I can’t think of anyone that would argue that healthcare doesn’t have a challenge reading physician’s handwriting. No doubt there are plenty of exceptions to this, but even those with beautiful handwriting still have to read other doctors’ handwriting from their own office or from other doctors’ notes that get sent to their office. It’s great to have the notes, but if you can’t read them then what’s the point.

While certainly illegible handwriting is a major problem in the office, it also extends outside the office as well. Think of all the times pharmacists have had to call a doctor to clarify the prescription a patient brought in. Even worse than that is the number of times the pharmacist misread a script because a doctor’s handwriting is illegible. This becomes a non-issue in an electronic world where the prescription is either printed or ePrescribed.

Of course, none of this is new territory. Every doctor understands these benefits better than I’ve explained here. However, far too often when we think about implementing an EHR, we forget about these simple and easy to understand benefits. How much time is saved in your clinic by being able to read the handwriting in the chart? How much time is saved in healthcare when referrals come in an easy to read, legible format? How much time and how many lives are saved by pharmacists getting the proper prescription to the patient? All of these are hard measures to quantify, but they are real, tangible benefits of an EHR.

I won’t mislead you into thinking the shift from paper charts to EHR solves all the legibility problems. Many template driven EHR software that creates a mass of mostly irrelevant data can be just as hard to decipher as the hieroglyphic handwriting of some doctors. However, I’ve seen a tidal wave of push back against these documentation approaches and I think we’re getting better. I think the shift to quality of care reimbursement versus procedure based reimbursement will help this to go away as well.

There are other things a clinic leaves behind with paper charts. I’ve heard many tell me how many times they looked at the handwriting to recognize who had documented something in a paper chart. Certainly that same info is available in an EHR, but you do lose the instant recognition of who charted what in the chart.

Despite not being able to put a nice dollar value on the Legibility of Notes, it’s certainly an EHR benefit that can’t be forgotten. It’s very easy to adopt an EHR and take this for granted.