Monday, April 21, 2008

Electronic medical records, limits of technology - Bad Rap on Physician IT Use Not Deserved

Many physicians are actually very savvy, particularly when it comes to online interactions—99% of all physicians now use the Internet, according to a recent poll. In fact, I would say physicians are ahead of the curve when it comes to finding practical, professional uses for Web 2.0 technology.

Elyas Bakhtiari, “Physician 2.0,” HealthLeaders Media, April 17, 2008

I was pleased when I ran across the above quote. Generally,among pundits, government officials, and IT aficionados, physicians get a bad rap when it comes to adopting EMRs, e-prescribing, diagnostic support systems, and other IT paraphenalia.

The attitude seems to be, if information is computerized, it’s got to be good.

Wrong. It can be bad, too, when it’s too much, too soon – poorly designed, user-unfriendly, and unhelpful. What physicians want is simple, useful information when it’s needed – when sending a patient to the emergency room, or helping a patient with a newly diagnosed cancer navigate the system.

Most physicians know exactly what they’re doing. Many of the systems aren’t yet ready. And doctors aren’t ready for systems that cost too much, take too much time, require excessive documentation, slow them down, don’t meet their needs, threaten patient privacy, reward health plans and government, harass them, unnecessarily complicate their practices, and are clearly not yet up to speed for clinical prime time.

The time for practical, simple systems that improve care and make it safer will no doubt come, but for most doctors, we’re not there yet.

But physicians are ready for being paid for email communication for patients, for installing practice websites to speed scheduling, educating patients, refilling prescriptions, for reading pertinent helpful blogs from colleagues, for seeking information on google and other sites, , for educational wikis (, for sharing videos (Doctor Channel, Inc), for hanging out with colleagues (, and exchanging views on such powerful and easy-to-use online social networking sites such as

1 comment:

Joe Grossberg said...

"Most physicians know exactly what they’re doing."

With all due respect, I think this misplaced confidence is a part of a problem.

No matter how well a doctor does his or her job, there is always room for innovation and improvement.

For example, I have enormous confidence in my physician.

But tracking my medication history/dosages means thumbing through pages and pages of handwritten notes, to compile the information.

And getting a new prescription means deciphering his sloppy handwriting.

Surely that's not a matter of the "system" not being ready.

Forget a totally automated and computerized practice -- I'm 31 years old and have met exactly one doctor (a gastroenterologist) who bothered to type his notes into a laptop.

I agree that there are reasons to be cautious about adopting new technologies prematurely, but I also feel that many doctors (like nearly all other people) are resistant to change when their old system "works" and look for ways to rationalize that instinctive response.