Electronic medical records (EMRs) offer the promise of facilitating more efficient, high quality care. To fulfill the promise, EMRs need to lead the way in re-engineering the way medical information is collected, processed and utilized. This promise will not be fulfilled, however, if the EMR simply converts the paper medical record into an electronic record, using the same formats. EMRs should be able to solve the challenges of workflow automation and allow for a more mobile platform in which to collect data, but if an RN is now entering blood pressure into the EMR, much as was done in a paper record, is there any efficiency advantage for that RN? I would argue there is not.
Medical journals are now commenting about physician progress notes in the EMRs; many notes are simply copying all prior physician notes and pasting back into the record with a new date, making the notes redundant and meaningless. This is an example of trying to use the paper medical record format in an EMR environment.
EMRs need to allow for automated data entry from digitized sources, but the data need to be converted into medical information with decision support, gaps in care prompts, and other innovations to improve individual patient care. But even that is not enough. EMRs need to allow physicians, nurses, and other health care professionals to manage entire populations, not just the patient sitting in front of them at the time. This is the true promise of a fully integrated EMR.
Dr. Michael Taylor
Chief Medical Officer