EMR/EHR Flaws

For everyone who thinks Electronic Medical Records are perfect than you should see this article.    It seems Drexel University’s Scot Silverstein is a renowned critic and I love it.   Here are some great highlights from the piece:

  • “We’re in the midst of a mania right now” as traditional patient charts are switched to computers, he said in an interview in his Lansdale home. “We know it causes harm, and we don’t even know the level of magnitude. That statement alone should be the basis for the greatest of caution and slowing down.”
  • But the notion that electronic charts prevent more mistakes than they cause just isn’t proven, Silverstein says. Government doesn’t require caregivers to report problems, he points out, so many computer-induced mistakes may never surface
  • He doesn’t discount the potential of digital records to eliminate duplicate scans and alert doctors to drug interactions and unsuspected dangers.  But the rush to implementation has produced badly designed products that may be more likely to confound doctors than enlighten them
  • A growing collection of evidence suggests that poorly designed software can obscure clinical data, generate incorrect treatment orders, and cause other problems. 
  • He believes in the potential power of electronic records for good, he says. But any doctor who feels bound by the Hippocratic oath’s injunction to “first, do no harm,” he adds, should balk at what’s going on.
  • “Patients are being harmed and killed as a result of disruptions to care caused by bad health IT,” he said. “I’m skeptical of the manner and pace” of implementation, “not of the technology itself. . . . My only bias is against bad medicine. And my bias is against people with complacent attitudes about bad medicine.”
Cheers to you Dr. Silverstein!  And keep up the good fight.

 

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  3 comments for “EMR/EHR Flaws

  1. Dr. Bill Ameen
    March 4, 2013 at 12:58 am

    Our hospital-owned urgent care is in its 8th month of using Allscripts, and is now in process of being bought by a university hospital which uses EPIC. By next year 65% of all hospital systems in our state will be on EPIC, so we’ll have to transition into it. Maybe EPIC has won the national battle to be the “go-to” EHR/EMR when we get national socialized medicine (I believe in 10-20 years). That said, I reiterate what I said on Sermo some months ago, that medical care is probably not a whole lot better than when doctors kept charts on index cards. (The average American lifespan in my opinion has risen from 65 to 83 in 40 years more from smokers quitting and people exercising and eating better and wearing seatbelts than from almost anything we doctors have done, with the possible exception of statins!) The value of EMR is that my handwriting is more legible, and in some cases electronically portable. Other than that, it adds at least 10-15 more minutes per patient for documentation. At least I don’t get writer’s cramp anymore! And if I’d known I’d have to type before the end of my career I’d have taken typing in high school in 1964!!

  2. February 27, 2013 at 11:55 am

    Question: Is “First Do No Harm” From the Hippocratic Oath? Myth vs Fact

    Answer: A question was raised in the Ancient / Classical History forum:
    “Having just read the translation to English of Hippocrates’ oath, I was surprised to see that ‘first do no harm’ did not appear in the text as is commonly quoted. Any idea where the quote comes from?”
    You’re right, the dictum first do no harm doesn’t exactly come from the Hippocratic Oath, but it does come from the Hippocratic Corpus, at least in esssence. A related section from the Hippocratic Oath has been translated as
    I will follow that system of regimen which, according to my ability and judgment, I consider for the benefit of my patients, and abstain from whatever is deleterious and mischievous. I will give no deadly medicine to any one if asked, nor suggest any such counsel; and in like manner I will not give to a woman a pessary to produce abortion. With purity and with holiness I will pass my life and practice my Art. I will not cut persons laboring under the stone, but will leave this to be done by men who are practitioners of this work. Into whatever houses I enter, I will go into them for the benefit of the sick, and will abstain from every voluntary act of mischief and corruption; and, further from the seduction of females or males, of freemen and slaves

  3. Kathy Wire
    February 26, 2013 at 7:57 am

    I remain convinced that the decision to support/mandate private and proprietary solutions was a huge mistake. Had the government (as a huge payer and consumer of healthcare) supported a common, open-source platform like VistA, we would be in a whole different situation now.

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