Electronic Health Record Quality
Here is the link to a study published in the Journal of American Medical Informatics Association. First all, the fact that they need a continuing journal with grant funded studies on EHR/EMRs is just how far we have lost touch with humanity. But below is the first section of the abstract. Read the objective of the study:
Physicians who more intensively interact with electronic health records (EHRs) through their documentation style may pay greater attention to coded fields and clinical decision support and thus may deliver higher quality care. We measured the quality of care of physicians who used three predominating EHR documentation styles: dictation, structured documentation, and free text.
Did anyone else laugh as they read this? Just visualizing some doctors intensively interacting with their computer was hilarious to me. I know some docs who have so intensively interacted with their computer that they broke it. Others had to wipe off the screen (joking). Anyway, so the premise of the study is what really bothered me. They forever in their mind link up that EHR use and clicking “coded fields” will equal higher quality care. Can you see now why I get so crazy when people throw the term “quality” around?
This study was sent to my by John who said:
I guess talking and listening to your patients is inferior to having your nurse run a largely irrelevant checklist which provides much useless repetitive information for overdocumentation and overbilling. Patient clinical outcome was not important enough to be addressed in this study.
Thanks for sending this gem in!
All of these computerized, electronic health records and their potential for assisting with quality of care hinges upon correct data for that patient being in those records.
With medical identity theft, information from the real patient and the identity theives can be co-mingled. As a victim of such a crime over a decade ago, the electronic records that exist on me have *3 different blood types* in them, among other things that are not true about me. If I were in an accident and someone relied upon this information to give me a transfusion, they’d have a fair chance of killing me. These seem to be not correctible!
In going into another clinic with a family member, the records were open on the screen of another patient, presumably one who had just previously used that room. In addition to allowing a patient access to records in violation of a host of privacy laws, the doctor could inadvertently put things that pertained to my family member in the record of this other person. It would not only confuse the record of the other patient, but treatment of my family member would go undocumented as well.
It would ensure that notes and charts were more legible, which would be a good thing in some cases. But, if these end up touted as a time-saving measure as well, the potential for acting upon wrong information is high.
In the words of Charles Babbage,”On two occasions I have been asked, ‘Pray, Mr. Babbage, if you put into the machine wrong figures, will the right answers come out?’ I am not able rightly to apprehend the kind of confusion of ideas that could provoke such a question.”
Anyone who purports to measure “quality” of medical care should be considered a charlatan until proven otherwise.
Anyone who reports a “quality” measurement with a single number is a charlatan. Don’t waste time listening to some attempt to prove otherwise.
And just WHO funded this study? It’s agenda is obvious.