Doctors and Patients and Paperwork

Posted on April 23, 2010 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 was reading through a thread over on EMR Update which talks about this New York Times article. Here’s some really interesting quotes from both sources that are worth considering:

In “The Hostile Hospital,” from the Lemony Snicket “Series of Unfortunate Events” books, the three young orphans at the center of the story visit the fictitious Heimlich Hospital, where Babs, the head of human resources, asks them if they know what the most important work done in a hospital is.

“Healing sick people?” one of the children asks innocently.

“You’re wrong,” Babs growls, silencing the children. “The most important thing we do at the hospital,” she continues without flinching, “is paperwork.”

Humor is the most funny when it stabs so close to the truth.

Currently, most systems have been designed not with clinical needs in mind but to meet the demands of the fee-for-service payment system. The software rapidly codifies diagnoses and symptoms, thus facilitating billing.

No worries though. The EMR billing machines that we have now will soon be replaced with EMR meaningful use machines. {a little satire of my own}

While EMR can capture certain information like medication lists and test results with mind-boggling accuracy and efficiency, it often fails to relay the nuances of a patient’s illness course. “Physicians think in stories,” said Dr. C. T. Lin, a practicing internist and chief medical information officer for the University of Colorado Hospital in Denver, which has used electronic records since 1994. “How can you possibly point and click your way through a patient’s 10-year history?”

This reminds me of the rather compelling video I did with Mmodal where they talk about the need to have both the narrative and granular data in the EMR. I’m always amazed at a physicians ability to look at a narrative section and get the story of what’s happened. Something that lists and results just can’t do justice. As valuable as those lists and results can be in other ways.