DISCUSS: Electronic medical records: bad, ugly, and dangerous?
25 Oct 2009 - 8:44am
3 years ago
There's a fascinating article in the Washington Post this morning
about the failure of electronic medical records in U.S. hospitals and
clinical settings: http://bit.ly/2Rb7lG
There are obviously a lot of culprits in this story -- design isn't
the only issue. But I'd be interested in hearing back from any of
you who've worked on medical records or devices. Do the issues and
problems presented here sound familiar? If so, how did you overcome
You may need an account to read the article, so I'll summarize the
- There's a strong incentive to adopt EHRs: Under Obama's stimulus
program, hospitals and physicians can claim millions of dollars for
IT purchases, and will be penalized if they do not go digital by
- While some studies show that electronic records reduce mistakes and
benefit outcomes, anecdotal evidence suggests major problems.
- Complaints about existing systems include: Faulty software that
miscalculated intracranial pressures and mixed up kilograms and
pounds and a computer system that systematically gave adult doses of
medications to children.
- Small, often unwilling, user base: Barely 8 percent of U.S.
hospitals have even a basic electronic medical system. Only 17
percent of physicians use electronic records, and many of those are
- Data entry takes too long: Physicians spent nearly five of every 10
hours on a computer. "I sit down and log on to a computer 60 times
every shift. Physician productivity and satisfaction have fallen off
- Poor design and usability: "I can't tell from the medical display
whether a patient is receiving 4mg or 8mg of a certain drug. It took
us two years to get a back-button on our [EHR] browser."
- IT-related mishaps are hard to quantify: Electronic medical records
are not classified as medical devices, so hospitals are not required
to report problems. Many health IT contracts do not allow hospitals
to discuss computer flaws.
- EHR systems are mission-critical: "The system crashed soon after
it went online. I walked in to find no records on any patients. It
was like being on the moon without oxygen."