EMRs Fail at Doctor and Patient Engagement

As taxpayers, we have subsidized the purchase of electronic medical records systems to the tune of $30 billion, creating the new EMR billionaire club, but has this investment paid off?  There is no evidence thus far that the quality of care has improved due to these investments.

The AMA recently called for a “design overhaul” of the entire system because they currently “fail to support efficient and effective clinical work. (article)”  EMRs were designed to satisfy regulators, not doctors or patients, that is the problem.  

In my conversations with hospital executives, many of them still have trouble managing seamless care transitions unless all of the caregivers are all on the same EMR, which is not the case in the vast majority of instances.  Getting a patient’s care plan from a hospital or PCP to a nursing home should be automatic, but it is not.








EMRs even fail at their primary objective, supporting a busy physician.  A recent Rand Survey indicated specific aspects of current EHRs that were particularly common sources of physician dissatisfaction included poor usability, time-consuming data entry, interference with face-to-face patient care, inefficient and less fulfilling work content, inability to exchange health information, and degradation of clinical documentation.  In “4,000 Clicks: A Productivity Analysis of Electronic Medical Records in a Community Hospital,” the authors estimated that a typical physician in the ED approached 4,000 mouse clicks during a busy 10-hour shift.  If this time could be saved and applied to patient care, the LWOT rate, or those patients who presented but “left without treatment”, could be eliminated AND an additional $153,300 could be generated in ED practice revenue.

This is the significant cost borne by all of us for poor application design and the power of a resistant, incumbent EMR oligarchy.