One ED Doctor’s View on EHR: A “Certified Nightmare”

I’ve written more posts than most about doctors and the EMRs they love to hate. But too often, observers like myself are forced to share stats from research organizations or (potentially suspect) ratings by groups like KLAS that poll doctors. Not only are stats a bit sterile, they gloss over some of the idiosyncratic issues doctors face when they take on an EMR.

This time, I had the pleasure of a heart to heart with an ED physician. I got more out of our brief conversation than I have in months of writing up survey “results” from interested parties.

The physician, a left-coaster who works with a large non-profit chain, spent a bit of his time telling me about his experiences with his EHR, which is installed in hospitals where he works.

His conclusion:  his EHR deserves the “Certified Nightmare” nickname it’s won among the medical staff.  From what he says, the EHR installation he’s dealing is way too hard to use.  To him, the user interface imposes a nasty “click burden” that slows him down needlessly.

Before you leap to the conclusion that he’s a Luddite, know that our friendly ED doc is completely paperless at home and that this EHR isn’t his first EHR.  He’s actually pretty fluent with technical stuff.

So I have to believe him when he says that the EMRs he’s looked at are clumsy as heck. “The height of EMR design seems to be Microsoft Outlook 2003,” he says. I wish he was wrong!

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.

5 Comments

  • Thank you for being willing to listen to someone who actually uses these things.

    Health IT news is such an echo chamber. I laugh and shudder every time there’s “white paper” about the amazing benefits of MediCompuTex3000 or whatever.

    In the trenches, this stuff pulls us away from our patients, gobbles precious mindshare, and is sometimes downright dangerous. And it’s not just click counts that are the problem. Every unintuitive click or unnecessary checkbox steals something away. It might be the way a pain was described, or the look I was given as I left the room, or the 6th critical thing I am remembering in a long list of critical things. But once I am clicking away, it is gone, to the detriment of my patients.

  • Brian,
    We do what we can to talk to as many providers as possible. I’ve been to conferences like AAFP with just that in mind.

    Your last paragraph intrigues me though. Couldn’t you just as easily lose something once you dive into a paper chart as starting to click away? I’m against “Certified Nightmare” EHR as much as the next, but some of the challenges you describe were and have been a problem on paper just as much as with an EHR. If done right, it could be less. If done wrong, then I can see your concern.

  • Your question is good, but the answer is definitely no. When I am ordering a non-contrast brain CT for a male patient on paper, I am not prompted to enter 1) whether the patient is allergic to contrast (which I am not ordering), 2) whether the patient is pregnant (duh?) 3) Whether the order should be for now or some time in the future, 4) whether it should be stat or routine, or 5) an indication from a list of indications, none of which remotely describes why I am ordering the scan.

    And there it goes–I had been reminding myself to go examine that unusual thigh bruise once I was done with this altered patient, and ask about recent travel etc… But now it’s gone. 5 clicks that didn’t need to happen and now my patient will never know she has Lyme disease.

    We physicians hold ourselves to very high standards and it is clear that EMR vendors hold themselves to “just good enough.”

  • […] Not everything on the internet is valid and sometimes it is just downright foolhardy. Anyone can set up shop and be an expert on any topic. Without appropriate digging, no one is the wiser.  A case and point, PCOS nutritionist, Monika Woolsey points out, women often incorrectly self–diagnose PCOS, based upon internet information, when in fact they have other conditions. Examples like this abound and lead many physicians to resist e-health trends, including the concept of empowered patients and the very real need for electronic health records. […]

  • […] Not everything on the internet is valid and sometimes it is just downright foolhardy. Anyone can set up shop and be an expert on any topic. Without appropriate digging, no one is the wiser.  A case and point, PCOS nutritionist, Monika Woolsey points out, women often incorrectly self–diagnose PCOS, based upon internet information, when in fact they have other conditions. Examples like this abound and lead many physicians to resist e-health trends, including the concept of empowered patients and the very real need for electronic health records. […]

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