Would An EMR Have Improved My Son’s ED Care?

Sure, EMRs can make some care processes better, but do they have an impact which patients would notice quickly from their first moment on?

After watching my son spend about seven hours in a pediatric ED waiting to be admitted – as part of a seemingly EMR-free process – I found myself wondering whether the presence of one would have made a difference.

The facility itself is a very reputable children’s hospital, one which attracts not only top physicians but also some of the sharpest pediatricians-in-training to its residency programs. And it doesn’t lack money to throw at EMR adoption. But from all appearances, digitizing records isn’t high on its agenda.

During our visit, the staff was very attentive, paying minute attention to my little one’s concerns despite his being in a particularly fractious mood.

At each stage in his evaluation, I had the sense that staff members had shared information effectively with each other (though admittedly, three different people did have to photocopy his insurance card).

The on-call resident summoned to evaluate him for admission was even lower-tech, if possible. During her interview with him, she took only a few brief notes on sheet of paper covered with jottings of various kinds.  She seemed to capture everything necessary for planning his care.

As I had questions, I stuck my head out into the old-fashioned workstation area and lobbed them over to the charge nurse. She found out whatever I needed to know, and when I had a bit of extra background to offer, she captured it quickly.

Of course, there was plenty of high-tech equipment in the ED, and it played a role in my little man’s encounter. But during his entry process, at least, information was gathered, summarized and shared effectively using purely old-fashioned methods.

If his care had been documented with an EMR, I know things might have worked a bit more smoothly during future visits, as the facility would already have the basics of his background on file for easy reference.  But wouldn’t a robust PHR do the job just as well?

Any physicians involved in his care would probably access the old triage and interview notes via their iPad or smartphone, making them more prepared when they arrived to chat.  Still, the resident on his current case knew nothing when she got here, and things went fine.

The hospital, and physicians, could use the data on his case to gather a better picture of how they’re treating kids with his diagnosis.  Not much to gather in this case, though. Does the possibility of adding him to some registry or dataset justify the expense of doing so via a Cerner or Epic investment?

Ultimately, I can’t think of any way an EMR would have offered a direct, concrete benefit to him this time around.  If not, why should I care that nobody involved in his care used one?  More importantly,  for this forum,  why should the hospital care?

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.


  • “But wouldn’t a robust PHR do the job just as well?”

    It would have. I can’t believe you wouldn’t have a PHR of information on your son. Oh wait, neither do almost every other mother in the world. Oh wait, if you did have it, your hospital likely wouldn’t have known what to do with it.

    Yes, it could have helped, but it’s not likely to help for a long time to come.

    To your other comments, sounds like an EHR could have been beneficial in the ED. In fact, there’s a whole class of ED EHR that focus on their specific needs.

  • Why tag the EMR/EHR one way or the other? Yes, it’s the topic in the news, but the real issue is how does that hospital manage its bed capacity.

    Capacity Management is a real challenge because it requires senior management to lead disparate groups (inpatient unit based care teams, inpatient physicians, “admitting” or sometimes “patient access services”, ER, facilities management/environmental services, patient transport services and I could go on. Senior management has to help these groups find a way to optimize the experience for all patients, even while (realistically) de-tuning the experience for some of the staff–clinical, administrative and support staff alike. An EMR/EHR can help in the process by facilitating access to aggregated data for process improvement and facilitating communication around an individual patient, but in the main it’s a neutral bystander to the rest of the (bed) capacity management effort.

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