A Country Doctor Writes:

When a new doctor joined our clinic, she spent a week learning our electronic medical record. She had used two other systems before, so she was no stranger to EMRs, but that’s how different they can be.

That’s crazy.

EMRs should be like cars, which range from the likes of Smart to Mercedes Maybach from Daimler, Mini to Rolls Royce from BMW or Skoda to Porsche from the Volkswagen group of companies. They range from simple to sophisticated, from nimble city cars to opulent highway cruisers.

There are occasional differences like type of fuel, battery, ethanol or gasoline powered, steering wheel shift paddles or voice controlled entertainment systems, and the driving experience varies wildly between marques but you could probably pick up just about any car as a rental vehicle, learn the basics and safely be on the road within just a few minutes.

For example, one country doctor, who shall remain unnamed, worked for over a year with an EMR which he explained to his patients wouldn’t tell him if any new reports had come in since they were in last. One day, by accident, he discovered a tab on the right hand panel of the computer screen, labeled DRTLA, that does just that – Diagnostic imaging, Referrals, Telephone calls, Labs and Actions, plus other incoming documents, neatly arranged. Somehow the implementation process skipped over that feature. That is just one of many functionalities of my particular EMR a new user wouldn’t be able to figure out very easily on their own.

A rental car would be considered dangerous if the shifter didn’t look somewhat like shifters in other cars, or if the windshield washer fluid and coolant caps weren’t easily distinguishable.

Similarly, a car would be considered unsafe and illegal if the windshield was only a few inches wide, and if drivers had to press a button or two in order to see the whole road in front of them. But that is how each lab report, like a Complete Blood Count, shows up on that same EMR.

And, now I know this, of course, but why is the “send” button on my prescription module marked “fax”, with a drop down menu choice of electronic prescription, which is the way we have to send prescriptions to comply with Meaningful Use? To confuse clinicians? I can think of no other reason.

A child, or a middle aged physician, can pick up an iPhone and quickly work the basic features by intuition, and wouldn’t be completely lost if suddenly handed an Android phone instead.

And, truth be known, my iPhone does some things better and faster than my million dollar EMR. And some inexpensive cars are more reliable than high prized exotics.