One of the topics I've written most about on this blog has been our woes with inefficient and cumbersome electronic medical records (EMRs). I started writing about this subject at least 3 years ago, because it's 1 of the issues I feel most passionate about. My own personal frustration in this area then led me to founding HealthITImprove, an organization which is dedicated to improving healthcare IT and decreasing the amount of time that doctors are spending with computers.
I've said it before and will say it again: information technology in its current state in health care, has done more to damage the doctor-patient relationship and the practice of medicine, than any other one single thing. Why is this? I know a lot of people who work in IT, and during my interactions and discussions with them, they unfortunately seem mostly clueless about what's wrong and why doctors (and nurses) are so dissatisfied with the situation.
In their world, it's all about keyboards and screens, and the more time anyone spends with them, the better. If any of these IT folk want to know what's wrong, let me put it quite simply. They take way too much time to use and suck the joy out of medicine. They also dramatically contribute to physician burnout and make doctors quite miserable. Heck, they even make patients miserable too—as one of patients' biggest complaints these days is that their doctor hardly looks at them in the eye any more, and is instead glued to their computer screen.
Now no reasonable person would want to go back to the days of paper charts. But there has to be a happy medium. One that fulfils the requirements of administrators and regulators, while also being good for physicians to use.
A study came out in the Annals of Internal Medicine within the last few weeks that garnered quite a lot of attention. It showed that for every hour doctors spend with patients, they spend 2 hours documenting on the computer (if anything, judging by my own experience, I was surprised that the ratio wasn't even worse). Did you hear that right? Because in no other field would a professional spend double the amount of time recording what they did, rather than actually doing it. That's such a profound statement that I'm going to say it again: in no other field would a professional spend double the amount of time recording what they did, rather than actually doing it.
Most people become doctors and nurses because they have a genuine desire to help and interact with people. If a doctor is spending most of their day on data entry and click box tasks on a computer, it's a travesty to the art of medicine and what it means to be a good physician. This article on KevinMD put it nicely when it said that the public would be shocked with what the typical day of a doctor now involves, and how far it is from the public perception. We have steered the health care ship badly off course over the last decade, and we now find ourselves at a crossroads. Do we allow doctors to become nothing more than “type and click bots,” or do we stay true to the ideals of good and thorough medicine?
I personally hate spending so much of my day glued to the screen, and do everything possible to get back to my patients. I hope we are finally reaching a critical mass of like-minded physicians across the country. Healthcare Information Technology: we can't carry on like this anymore.