By using this site, you agree to the Privacy Policy and Terms of Use.
Accept
Health Works CollectiveHealth Works Collective
  • Health
    • Mental Health
    Health
    Healthcare organizations are operating on slimmer profit margins than ever. One report in August showed that they are even lower than the beginning of the…
    Show More
    Top News
    What Are the Benefits of CBD?
    November 27, 2021
    How to Measure Adult Diapers- The Ultimate Guide to Picking the Right Size
    March 8, 2022
    medicine cabinet
    The Effect Of Finished Dosage Form Manufacturing In New Drugs
    July 5, 2022
    Latest News
    Getting Back in the Game: Sports Injuries Rehabilitation Tips
    May 31, 2023
    4 Signs It’s Time to See a Therapist
    May 24, 2023
    11 Ways To Modernize Your Private Practice
    May 17, 2023
    How to Recognize the Signs of Hormonal Imbalance in Men
    May 29, 2023
  • Policy and Law
    • Global Healthcare
    • Medical Ethics
    Policy and Law
    Get the latest updates about Insurance policies and Laws in the Healthcare industry for different geographical locations.
    Show More
    Top News
    Tai Chi Combined with Proper Meds Reduces Depression in Elderly
    May 5, 2011
    Incidence and Prevalence of Morbid Obesity
    June 21, 2011
    High Levels of Physical Activity Could Reduce Silent Stroke Risk
    July 24, 2011
    Latest News
    MRI Sedation Options: What You Should Know Before Screening
    May 17, 2023
    What is the Process of Creating Medicine from Nature?
    May 2, 2023
    Choosing the Right Treatment Option for Varicose Veins
    May 2, 2023
    What Are Wrong-Site Surgeries and How Do They Occur?
    April 27, 2023
  • Medical Innovations
  • News
  • Wellness
  • Tech
Search
© 2023 HealthWorks Collective. All Rights Reserved.
Reading: The Electronic Medical Record Doesn’t Tell You the Story
Share
Sign In
Notification Show More
Aa
Health Works CollectiveHealth Works Collective
Aa
Search
Have an existing account? Sign In
Follow US
  • About
  • Contact
  • Privacy
© 2023 HealthWorks Collective. All Rights Reserved.
Health Works Collective > eHealth > Medical Records > The Electronic Medical Record Doesn’t Tell You the Story
Medical Records

The Electronic Medical Record Doesn’t Tell You the Story

Wing of Zock
Last updated: 2012/05/07 at 8:10 AM
Wing of Zock
Share
6 Min Read
SHARE

By Karen Sibert, MD

By Karen Sibert, MD

One morning recently, I found another physician standing morosely at one of the mobile computer terminals we refer to as “cows”—computers on wheels—that are everywhere now in our hospital. I asked what was the matter. “Oh nothing, really,” she said. “It’s just that I don’t feel I know the patients as well as I used to.”

I knew exactly what she meant. Things are different now that we have the EMR, the electronic medical record. After two months of use, we’ve learned to our sorrow that these records don’t tell us stories that make cognitive sense. They offer information in endless lists.

More Read

password management for healthcare companies

Hospital software with high ROI

Critical Measures for Stopping Terrifying Hospital Data Breaches
How Hospitals Can Protect Patients From Identity Theft
A Guide To Transitioning Your Chiropractic Practice To Telemedicine
How HIPAA Applies to Medical Marijuana Businesses and Patients

Before the written word, people told stories. In every culture, around hearths and on journeys, they remembered and retold tales of great deeds, romance, and tragedy. When we were medical students, we learned to present each case on rounds by telling the patient’s story. The story had well-defined elements: the current complaint, the background of genetics or misfortune that led up to the present, the investigation that might clinch the diagnosis, and the plan of action.

The best stories almost told themselves. The business executive fresh from a transatlantic flight presented with shortness of breath; VQ scan revealed a pulmonary embolism. The young woman with Marfan’s syndrome began exercising one morning and developed severe chest pain radiating to her back; the echo demonstrated aortic dissection.

Now, however, we have lists.

One list will give us the medical history. In no particular order of priority, it includes one-word problems such as osteoarthritis or hypertension that have nothing to do with the patient’s current admission for acute pancreatitis. The relevant history of alcohol abuse may be found elsewhere, in the list under “social history.” Our “social history” includes a field that will tell you whether or not the patient chews tobacco, which is so seldom helpful in southern California. The complaint of abdominal pain won’t be found anywhere near the list of laboratory values with the important amylase and lipase levels.

If you’re a consultant trying to make sense of the patient’s case, you can find yourself frustrated and stymied at the difficulty of getting the big picture. If you’re lucky, you can find a human who knows something about the patient, and get him or her to tell you the story. You can bet that this won’t be the resident, who has just come on the service, didn’t admit the patient, won’t be following the patient, and will have to lie down for a nap soon. But with perseverance you may find an attending physician who has no duty hour restrictions and actually knows what’s going on with the patient.

If finding a human fails, your second hope is to find a narrative note by a physician who is in the old-school habit of dictating an organized history and physical. This is the pot of gold in the EMR, but you may have to sift through pages of notes on the computer before you find one. Sometimes, just for fun, I print it out so I can refer back to it without logging on to anything.

The use of all the “smart fields” in the EMR looks appealing at first until you realize that they propagate themselves endlessly, like tribbles. The same “past medical history” will appear as an identical list in note after note, because it’s so easy to type “.pmh” instead of summarizing the patient’s problems as a narrative. If an error of any kind is made, it will continue until someone notices and takes the trouble to delete it. If “Lasix” instead of “latex” is entered as an allergy, it may be listed that way indefinitely. You’re much more likely to click on the wrong line of a list than you are to write down the wrong information in a handwritten note.

With the billions of dollars that are being spent on EMRs, and the Obama administration’s keen interest in their implementation, no one wants to hear about the problems they cause. But the truth is that it’s much harder for physicians and everyone else in the hospital to learn and remember what they need to know about their patients from reading electronic records. Human beings don’t learn best by memorizing disconnected lists. From fairy tales to patients’ histories, we’re hard-wired to remember stories.

—Karen Sibert, MD, is an anesthesiologist in Los Angeles. She blogs at A Penned Point.

 
 

TAGGED: doctor/patient relationship

Sign Up For Daily Newsletter

Be keep up! Get the latest breaking news delivered straight to your inbox.
By signing up, you agree to our Terms of Use and acknowledge the data practices in our Privacy Policy. You may unsubscribe at any time.
Wing of Zock May 7, 2012
Share this Article
Facebook Twitter Copy Link Print
Share
Previous Article Nothing About Me Without Me – Participatory Medicine, Meaningful Use, and the American Hospital Association
Next Article Robotics Are Revolutionizing the Delivery of Medical Care

Stay Connected

1.5k Followers Like
4.5k Followers Follow
2.8k Followers Pin
136k Subscribers Subscribe

Latest News

11 ways nurses can care for patients during mental health crises
11 ways nurses can care for patients during mental health crises
Mental Health June 6, 2023
test
Essential Steps for Starting Your Journey as a Fitness Instructor
Fitness June 5, 2023
mimosa pudica
Health Benefits of Mimosa Pudica: The Marvel of Nature
News June 2, 2023
medical bills
Who is Responsible for Paying the Medical Bills After an Injury?
News June 1, 2023

You Might also Like

Electronic Health Records
BusinesseHealthHospital AdministrationMedical Records

Top Benefits of Electronic Health Records for Psychiatrists and Psychologists

August 15, 2022
Medical EthicsMedical Records

A Guide to Medical Billing Services for Small Practices

January 26, 2022
what medical industry learnt from covid-19
Covid-19Medical InnovationsMedical RecordsTechnology

What Has the Medical Industry Learned from COVID-19?

October 19, 2021
paramedic software
eHealthMedical Records

4 Practical Reasons You Need an Efficient EMS ePCR Software

July 8, 2021
//

We influence million of users and is the most authentic source of information on healthcare business and technology news.

Quick Links

  • About
  • Contact
  • Privacy
Subscribe

Subscribe to our newsletter to get our newest articles instantly!

Follow US

© 2008-2023 HealthWorks Collective. All Rights Reserved.

Welcome Back!

Sign in to your account

Lost your password?