It has been almost a week since I posted anything. I haven’t been keeping up on medical news as well as I could have but I haven’t seen anything of real significant interest recently. So for this post I’m going to be giving a bit of my perspective on the benefit of electronic medical records (EMR). I have had the joy to work in several different hospitals/clinics since starting third year of med school and have worked with both paper and electronic records. I have to say that I am a big fan of electronic records. First of all, there was recently an article in the NEJM about how electronic medical records have been used to essentially harvest data and do quick patient population based studies to determine treatment outcomes. I thought it was a particularly interesting piece that demonstrated an entirely new and very practical use for EMR.
As far as my current experience goes, I have to say I prefer EMR. When it comes to paper charts I run into several problems. First, when following up on new patients that I haven’t seen before at an outpatient clinic I often have significant difficulty trying to decipher the previous notes. If the patient is following up on a specific problem, this makes understanding the current treatment plan difficult along with problems determining previously failed treatments. Fortunately for me, at the clinic I am currently working at, the previous third year student that had been working there has often seen the patients I am following up and and their hand writing is often significantly better than the attending’s. However, for when that is not the case it becomes a constant struggle and frustration to read many attendings’ notes.
As for the EMR system, handwriting is never a problem. Each note is typed up and easy to read. EMR also has the ability to sort notes by the type of visit. So if I want to specifically see how a patient is doing with their occupational therapist or pulmonologist I can find those specific notes quickly. Whereas in the paper charts they are typically all mixed together and you have to sort through each note until you find it.
When it comes to documentation of medications, a paper chart is only as good as the last person filling out the medication list. Now, I do my very best to make sure all the current medications are up to date in the chart and if the current form is too confusing due to med changes or dosage changes I will replace it so that it is easier to read. Of course I am only human and when the clinic gets busy it is easy to miss this step. Compare this to the EMR where, as soon as you put an order in for a new prescription for a patient, it gets recorded in their file for easy recall on their next visit.
Finally, when it comes to access of patient information quickly and efficiently EMR leaves paper charts in the dust. Picture a doctor’s office where every Physician has a tablet and while talking to the patient can easily put in medication orders or look up recent x-rays or labs and show them right on the tablet to the patient to explain them. Imagine trying to do that with a paper chart. In fact, often times we have to access outside records and print them out to put in the chart, if we don’t print them out and include them it’s as if those studies were never done when you come back to the chart later (since by then you will inevitably forget that an outside study was done in the first place). Also, as an added bonus most tablets are easy to clean by simply wiping them down. Try that with germ laden paper charts. The iPAD is already becoming a prominent tool in medicine and tablets in general could help revolutionize patient care at the bedside.
