Problems EMRs Don’t (Necessarily) Cause

In publications like this one, we spend a lot of time and energy clubbing EMRs and EMR vendors for the problems they cause.  That’s all well and good, but it’s also worth remembering that some of the big problems surrounding medical operations may not be due to EMR use:

* HIPAA carelessness:  When someone shouts private medical information across a room, or loses a flash drive or tablet with records on it, or leaves patient records in a public place, you’ve probably got a nasty HIPAA violation. But the EMR almost certainly had nothing to do with it.

* Clumsy office workflow:  Sure, introducing an EMR into a clinical setting can screw up existing workflow. But was it working well in the first place?  For those whose business falls apart post-EMR, I’d argue “no.”  Businesses that don’t do well after an install had jury-rigged processes in place already, I’d argue.

* Patient care slowing down:  As with staff workflow, clinical workflow can be discombobulated — badly — by an EMR installation. Learning to fit practice patterns to the system is a big job for most clinicians, and they may slow down significantly for a while. But if the patient care flow stays “broken” it’s likely that there were aspects of the pre-EMR system that didn’t work.

I realize that I might get flamed for saying this, but I’m pretty confident that a goodly number of problems that are laid at the feet of dysfunctional EMRs don’t belong there.  And that’s not a good thing.

After all, there are enough poorly designed, trouble-ridden EMRs out there to keep us busy critiquing them for a century or two.  Why distract ourselves by adding more to the pile when the real issues may be elsewhere?

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.


  • You are correct on the first two, but partially wrong on the third. EHRs do slow docs down…especially when:
    > the office never optimized their work flows for computerization
    > the doc blew off training…and is still complaining
    > the doc dropped the transcription service

    Dropping your transcription service is generally touted as one of those big savings of an EHR. Sure is saves money, but it also turns the doc into the transcriber. If the doc was a great typer before, he’d probably not be using a transcription service.

    Oh, and remember, you aren’t saving any money if you fire your transcriber yet need a nurse with you at all time to be your personal EHR input person.

    Add to that the 7 clicks it takes to get 1 meaningful use “counter” and time isn’t saved.

    I speak of this from being in the trenches and hearing docs gripe and seeing them in action.

    Can this be fixed? Sure, EHRs will (should) get better over time and the doc will (should) get quicker over time.

  • I can only speak to a couple implementations in the behavioral health world, but I would also agree with your points. I’ve heard countless times how the EHR is at fault (even though it improved performance 98%, we’re almost upset with the 2% it can’t do), even though it clearly hasn’t been programmed correctly and/or the workflows haven’t been optimized.

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