The Tragedy of Electronic Medical Records

In today’s Science Section of the New York Times, Abigail Zuger writes about the problems of computerized health records and how they contributed to the Ebola Case.  Please read her article, which is excellent. Readers who want to know more about these problems should read our book First Do Less Harm: Confronting the Inconvenient Problems of Patient Safety.  My co-editor Ross Koppel and his colleagues writes compellingly about the problems of Healthcare HIT.  Also read the article in the Dallas Morning News on hospital e-records.

Here is the comment I posted on Zuger’s article.

Electronic medical records also reduce the already limited time physicians, nurses, and other healthcare professionals and workers spend in conversation with each other consulting and planning care.  Physicians are now locked into specially constructed rooms huddled over their computers entering data into EHRs.  Ditto nurses.  People who have never learned to communicate and engage in genuine teamwork and who have never spent enough time communicating about critical medical issues in the past are now even more isolated from one another.  So not only do physicians and nurses spend less time actually in conversation with the patient (who seems, sometimes, to be a distraction from the computerized chart), they communicate less with one another.  In health professional schools all over the country there is a big push to produce interprofessional education and practice, where healthcare professionals learn with, from, and about each other and consult with each other.  Unfortunately, electronic health records and all sorts of other health care information technology is making a mockery of this effort.  So once again we are spending billions of dollars and failing to address the crucial problem Zuger identifies.  People need to learn how to talk to and with each other and learn from each other.  Computers are not making this easier.  They are simply exacerbating long-standing problems.