EMR Should Make it Easy to Do the Right Thing and Hard to Do the Wrong Thing

There’s a really good article by Paul Cerrato on Information Week which tells the story of how a flawed EHR could threaten a patient. While I can’t say I agree completely that the EHR was the cause of the issue described in the article, I do see how an EHR could have possibly prevented the issue if it had been used right.

The article offers the following conclusion:

They hope that these measures will in fact make it “easy for clinicians to do the right thing and hard for them to do the wrong thing.” Among their suggestions:
— Establish an electronic link between operative notes and the EHR problem lists. Doing so would automatically insert “splenectomy” in the latter.
— Use billing data to identify patients who have had the surgery and let the billing data “talk” to the physician through the EHR system, prompting the physician to add that fact to the problem list.

I don’t think these electronic fixes are enough. The real solution is one that nobody in the healthcare reform camp wants to hear: Short of implanting a microchip in every doctor’s head, the simple truth is each clinician needs to see fewer patients and spend more than the typical eight minutes with each of them. And they need more time to manage all the thousands of tasks they have to perform daily. Obviously, this isn’t going to happen anytime soon. But that doesn’t make it any less true.

Those are some good suggestions. Of course, the first suggestions all focus on getting the right information into the EHR so that the doctors have that information when they’re treating the patient. This is a challenge that is really eternal. I do like some of the things they mention. Some of which are already possible.

The last suggestion is a hard pill for healthcare to swallow. More time with patients, in our current reimbursement model, translates to lower pay.