I remember a day , 14 years ago, when our medical director met with a large Urgent Care group about the switch from paper charts to an Electronic Health Record. (EHR).
I thought to myself – “Uh-oh, we are going to lose something here.”
I wasn’t mistaken.
Our paper charts were basically a one page sheet, which contained all of the patents information in abbreviated form, – including age, chief complaint,, history of present illness, medications, allergies and review of systems.
There were a couple of open blocks of space to write on for physician exam, assent and plan, and a second page for billing.
The size of form itself required narrowing the focus of the evaluation, perfect for most urgent care patients.
This paper form was sufficient for 95% of our patient visits.
Now, when we were “upgraded” to an EHR, we suddenly had the capability to store much more information – an unlimited amount, in fact.
The downside? It requires multiple different screens to enter this information, and it requires multiple different “clicks” to view this information.
Effectively, we gained both a significant amount of information, AND an ability to do extensive backend processing, BUT at the cost of both simplicity, focus and an easy to evaluate birds-eye view.
Was the change form paper charts to EHR really an upgrade?
It probably depends who you ask.
To the administrators, the billing folks, and the insurance people, undoubtedly, but to both the physicians and patients, it’s a lot less clear.
There have certainly been times when having an EHR has helped a given patient. For example, it’s great having a real time ,over-read on a complicated X-ray within minutes of the test with a patient still in the room.
But at least as frequently, the EHR in the room gets in the way of actually seeing and communicating with the patient as a human being.
So what’s the key take home here?
When it comes to actually helping a patient, we shouldn’t assume that technology is always a net benefit.
Often we lose as much as we gain.