Unnatural Human Communication, The Main Barrier to Electronic Medical Records

To hear the electronic online crowd tell it, EHRs are the Holy Grail for improving and rationalizing the health care system.

At one stroke (and multiple key strokes), EHRs will,

• Reduce medical errors

• Narrow disparities in care delivery

• Engage patients in their own care

• Spark coordination of care

• Give access to doctors to best practice information

• Enhance communication across the health care spectrum

Besides, EHRs will replace and overcome those dreadful paper records, which are,

• Space-occupying

• Irretrievable

• For physician-eyes only

• Private, personal, and secure

• Individualistic

• Fragmenting the system

Order Out of Chaos

EHRs are, in short, a way to bring order out of chaos and to reduce the world to a series of electronic bullet-points, around which everything can be organized, everything is logical,everything can be encapsulated, and everything can be presented and understood as a kind of Powerpoint Presentation.

The main trouble with all of this is that EHRs and PowerPoint presentations cannot capture all the subtleties, permutations, and combinations of human interactions and reduce these exchanges into data bytes and bullet points.

As observed in today’s New York Times, “We Have Met the Enemy and He is PowerPoint, “ PowerPoint Presentations are akin to “hypnotizing chickens,” i.e., they look good, feel good, and mesmerize viewers, but lack the subtleties and nuances of humankind. Still, the chickens are crossing the communications road and seem to be in command of the road.

In today’s The Health Care Blog, Robert Rowley, MD, chief medical officer of Practice Fusion, Inc, writes in “Challenges in EMR Adoption by Doctors Offices,” that his company’s’ “free” EMR system, which allows small practices to install an EMR , quickly, with minimal training at no cost to the practice except having a computer with broad band access to the Internet, may be a starter for overcoming physician barriers to EHR adoption. These barriers include direct and indirect costs of installation and maintenance, diversion and distraction from seeing patients, and drops in productivity and income.

Dr. Rowley should know: his practice has been “paperless” since 2004.
and he may be right. The world is moving on Internet time at Internet speed, the paper world of newspapers and book publishing is going paperless, and we paper-bound creatures are groping for new paperless business models to survive.