Wednesday, February 07, 2018

New article in J. of General Internal Medicine calls for simplifying EHRs

At my January 31, 2018 Healthcare Renewal blog post "The inevitable downgrading of burdensome, destructive EHRs back to paper & document imaging" at, I opined that the downgrading of the clinician-facing components of EHRs was essential and inevitable. A new editorial in the Journal of General Internal Medicine makes similar points: ​Electronic Health Records: a "Quadruple Win," a "Quadruple Failure," or Simply Time for a Reboot?
Journal of General Internal Medicine
Michael Hochman

"Perhaps most importantly, there must be a dramatic and thoughtful simplification of EHR documentation templates: it should not take over 200 mouse clicks and more than 700 key strokes to complete one ambulatory encounter."


And this statement, seen frequently at this site, also appears:

"Put simply, EHRs must be redesigned around the needs of clinicians and patients rather than billers and administrators."

The article also makes many other points about the technology I've been writing about for decades, such as the now-obvious grossly exaggerated claims about benefits and cost savings, and others:

... many of the predictions about the benefits of EHRs have yet to materialize to the extent predicted. Though EHRs have facilitated some substantial improvements—the ability for clinicians to access charts from any wired location, electronic transmission of prescriptions, and enhanced tracking of population health measures, to name just a few—they have also resulted in numerous unintended consequences. Noteworthy concerns include egregious medical errors resulting from design glitches, charting templates filled extensively with meaningless boilerplate, the common practice of pasting old notes that makes it difficult to know which documentation is “real,” “alert fatigue” due to excessive EHR warnings (note that some warnings are essential, such as on critical actions with possibly serious consequences, e.g., on confusing screens that can be described as "hot spots for user input error" - ed.), and even reduced communication among clinical team members.

Note that you saw the idea about EHR simplification on Healthcare Renewal first.

-- SS

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