The younger doctors have been doing it this way their entire lives. The older ones don't want to do it at all and the middle-aged ones will be forced to change. What am I talking about? It's the advancing wave of of electronic medical records.
Digital technology has long been ubiquitous. Now it is being applied in a new realm: The description, diagnosis and treatment of the human body's pathology. It is attempting to force humans in all their complexity into a nice compartmentalized series of ones and zeros.
Electronic medical records were promoted as the solution for many health-care problems, including increasing quality of care and decreasing error; better, safer sharing of medical information among providers; saving institutions and providers money; and better for the environment.
Peter Pronovost, director of Armstrong Institute of Patient Safety and Quality at Johns Hopkins says that "medicine today invests heavily in information technology, yet the promised improvements in patient safety and productivity frankly have not been realized."
In fact, there are no definitive studies to show introduction of EMR improves the overall quality of care patients receive.
As a practicing physician I am dismayed that we are pressured with financial penalties by the government to use these unproven systems, but I am even more disappointed in the face-to-face consequences for patient care.
Does your physician look at you or the computer while taking a medical history? We are constantly bombarded in medical school about how much more important body language is in obtaining the history from a patient. EMR does not encourage that, and it really can't record it well.
When one looks at the big picture we can see where this is all going. The government is already initiating various "quality care" programs to try to link outcomes as measured by EMR with costs and to begin rewarding and penalizing physicians for their ability to care for patients electronically. Should we really rely on the templates generated by EMR to make cogent health-care decisions?
We need to back off mandating EMR use to only those situations where clear clinical benefit is demonstrated.
Clark Brill, Columbia