A couple months ago, we pointed to the concerns many doctors have about the capacity of EHRs to capture the details they rely on when diagnosing patients.
But this doctor is concerned about something even more basic: getting doctors to read the notes of physicians the patient has seen before.
In his straightforward terms, “one subtlety of the paper chart is gone forever; the expectation that your note will be seen by the next physician who writes in the chart.”
In broad strokes, he paints a compelling picture of how the flexibility of paper charts often works to enhance the amount of understanding that multiple physicians can bring to a single patient’s care. Underlined words, bold scribbles, a phrase that catches a subsequent physician’s eye; in his view, these and other quirks of handwritten notes combine to improve the potential overall quality of a patient’s care.
But, with electronic records, “the need to consciously choose to view a note actually discourages physicians from the process. Wanting to merely ‘glance’ at a previous note requires signing on, selecting the patient, opening up the relevant screen, selecting the pertinent note, and then scrolling through the documented information to find the desired section. Not really a system that optimally facilitates physician communication.”
Concerns like this are no reason to doubt the significant current and potential benefits of HIT, and this observer recognizes that the digital “train has left the station”. But such observations do serve as a necessary reminder that, at its core and despite whatever future technological advances, medical care needs to remain what it has always been: an interaction between humans who can communicate needs and responses in ways for which no machine should ever be considered an adequate replacement.
Jeff Rowe blogs daily at Priming the Pump.
