A large number of hospitals and physician offices still use paper-based records to keep patient clinical information. The gradual replacement of these records by electronic ones has been slowly happening in the last 20 years. However, healthcare still lags behind other industries such as finance, airline and retail in its adoption of computer-based records.
An Electronic Medical Record (EMR) is defined as:
"a type of clinical information system, which is dedicated to collecting, storing, manipulating, and making available clinical information important to the delivery of patient care. Such systems may be limited in their scope to a single area of clinical information (e.g., dedicated to laboratory data), or they may be comprehensive and cover virtually every facet of clinical information pertinent to patient care (e.g., computer-based patient record systems)."
While many experts argue that collecting patient medical information in a digital form that can be viewed on a computer and easily shared by all providers has numerous benefits, a new study suggests that it can also lead to serious problems in communication.
The study is entitled “Electronic Medical Records and Communication with Patients and Other Clinicians: Are We Talking Less?” and was recently published by the Center for Health System Change. It is based on a total of 60 in-depth interviews: 52 physicians and other staff, chief medical officers at four EMR vendors, and four national experts active in health information technology implementation.
The study found that EMRs assist real-time communication between doctors and patients during office visits by allowing immediate access to patient information and giving doctors the chance to talk with patients rather than search for information from paper records. One physician commented: “We do not have to call down the hall for a lab or test result, we spend more quality time [with the patient] in a more context-rich way."
Moreover, ease of access to information also improved patient education during visits. Doctors, patients and family members can review together on screen the problem list, medication list and care plan, or other educational information from the Internet.
However, EMRs appear to be a double-edged sword. For doctors, using a computer during a patient visit can be a distraction. A physician confessed: "It’s like having a two-year old in the room," while another noted "there are a lot of gadgets and gizmos and that can pull us away from our objective." For example, instant messages are valuable for communicating efficiently about care tasks and minimizing physical interruptions of visits, but they too can distract doctors from the patient if they cannot adequately manage or ignore IM alerts in the exam room.
The irony is that while EMRs were designed to improve communication and increase time spent with patients, they actually have enabled some doctors to engage less with patients because they have much more information before actually seeing the patient. One doctor was concerned that "we’re listening less because we have more information when we walk in the room, and it’s not all trustworthy."