Friday, July 22, 2005

EMR's are coming...perhaps not so fast

I agree with Egan that EMR's have the potential to be abused. The disquieting metaphor of clinicians becoming "glorified data entry personnel for third parties (to a greater extent than we already are)" is a distinct possibility unless clinicians take charge of the tools of their own profession.

On the other hand, to throw a monkeywrench into the beliefs of the optimists, there's this:

J. Am Med Inform Assoc. 2005 May 19; [Epub ahead of print]

The Impact of Electronic Health Records on Time Efficiency of Physicians and Nurses: A Systematic Review.
Poissant L, Pereira J, Tamblyn R, Kawasumi Y.
Clinical and Health Informatics, McGill University, Montreal, Canada.

A systematic review of the literature was performed to examine the impact of electronic health records (EHR) on documentation time of physicians and nurses and to identify factors that may explain efficiency differences across studies. In total, 23 papers met our inclusion criteria; five were RCTs, six were posttest-control studies and twelve were one group pretest-posttest designs.

... Studies that conducted their evaluation process relatively soon after implementation of the EHR tended to demonstrate a reduction in documentation time in comparison to the increases observed with those that had a longer time period between implementation and the evaluation process.

This review highlighted that a goal of decreased documentation time in an EHR project is not likely to be realized. It also identified how the selection of bedside or central station desktop EHRs may influence documentation time for the two main user groups, physicians and nurses.

PMID: 15905487

Ten year timeline to national EMR's in the U.S.? I recall that same timeline being championed - when I attended the AMIA conference (then known as SCAMC) for the first time in 1991.

-- SS

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