Reader Says EMRs Too Rigid For Most Doctors

My post on lousy EMR interfaces continues to stir reactions among EMRandEHR readers.  Those responses include the following, from reader Bret Shull:

Thank you for bringing up yet another important matter in the never-ending drama that is EMR.  Until a merger in Dec. 2009, I owned and served as administrator for a  4 physician diagnostic clinic in southern California.  While marketing our professional and clinical services over the years, I consulted with hundreds of practices and physicians regarding various practice management issues.  Based upon my inquiries, the vast majority of the providers who have deployed  EMR revert back to paper SOAP notes within a few months.

When asked why they go back to paper, they confess that they find EMR’s very rigid; the logic forces them into a completely unfamiliar (and often inferior) approach to their patient encounter. Subsequently, the physicians either stay after hours to type and click their notes into the EMR or delegate the arduous task to a staff member.  The comments I’ve heard from my referring physicians follow along these lines:

  • “I’ve been practicing medicine for 20 years… What do the people who designed this software know about practicing medicine that I don’t?”
  • “Why can’t an EMR learn how I practice instead of forcing me to assess my patient its way?”
  • “It seems the more we customize the templates, the more pull-down screens we create, making the system even more cumbersome.”

Even with the HITECH incentives in place, many physicians are still hesitant to “take the plunge”.  At the risk of stating the obvious, I personally believe the cumulative effects of these negative experiences throughout the market have served to stifle EMR adoption.

As it turns out, Shull did find a platform he liked eventually. He’s a big fan of the Praxis EMR, which he says works far more intuitively than the other systems he tried.

I can’t vouch for Praxis — or any EMR for that matter — but it’s great to hear that Shull’s was happy with what he found.  Has anyone else found a system they believe doctors will actually  use?

About the author

Anne Zieger

Anne Zieger

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.


  • That’s an interesting comment when compared with a post that Dr. West recently did on Happy EMR doctor about EMR templates improving patient care. It seems that he’d been under the same notions that are mentioned in the comment above. However, when he took the time to try the templates, he found that it increased his speed and also increased the quality of care he provided.

    Makes you wonder how much of it is that the EMR is too rigid and how much of it is people’s pre-conceived notions that the EMR can’t do what they want it to do (whether they’ve tried it or not).

  • Practice Fusion is our EMR system and it’s great. Very intuitive. I looked at Praxis, which also seems very interesting, and I can see why providers would like this one. I need to go back and watch the demo when I have time. For me, charting with an EMR is a learning curve, which I also did a post on, and it just takes time.

  • Praxis uses a concept engine approach, that is, as the user enters the details of an encounter, it shows how you diagnosed similar symptoms previously. It does this by showing you a bell curve of similar encounters that you have had.

    Its an intriguing approach. In the past, the EMR was hindered by lack of eRx abilities etc. To date, it has not achieved MU certification.

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