EMRs Should Be Like Rental Cars

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.

5 Responses to “EMRs Should Be Like Rental Cars”

  1. 1 Mary Ellen McColl March 2, 2017 at 4:07 am

    Exactly. Or it should be like my kitchen stove. Turn it on and it works and then off. Meals and cookies come out.

    Sent from my iPhone

    Mary Ellen McColl

  2. 2 meyati March 2, 2017 at 7:08 am

    And EMRs seem to be useless to mute patients. I lost my voice early last month- endoscopy. I can’t call. I can’t answer the phone. The doctors here use the EMR instead of Email or text. HIPPA doesn’t help either. They refused to talk to my son- hung up on him. They refused to talk to him in the exam rooms. I was hissing like a giant cockroach

    You’d think that in this diital-electronic age there would be some way for communication. I was told that my biopsy reports would be ready in 2-3 days. The results, negative, weren’t put in my EMR so I could know. They didn’t call. They didn’t mail. I sent them EMR messages telling them to call my son and tell him, or get them in the mail..

    The EMRs here have only non-Urgent messages. It takes days before there’s a reply or an appointment. The only uniform aspect of EMRs is their uselessness.

  3. 3 Dr. Kim March 2, 2017 at 9:41 pm

    Usually I am a passive reader but I have to comment! I am a doctor who is happy with her EMR! Check out ElationEMR (link below). It is incredibly user friendly, searchable and patients love it. All information alerts you when it’s new and you can sort pages however you want. Best for me is the ability to have several pages open at once which is how I like to operate. Would be happy to tell you more if you want to email anytime.

    • 4 acountrydoctorwrites March 2, 2017 at 10:38 pm

      I watched Matthew Holt’s interview on The Health Care Blog. Looks good. The problem I see is that there are too many different EMRs and too many different ways of doing this. I’ll date myself by saying it’s like Betamax and VHS times 100.

      • 5 meyati March 2, 2017 at 10:46 pm

        Remember when PCs came out in the 1990s? Each brand had a different USB port, etc. Congress took hold of it, and regulated a standard USB and port. I can use any keyboard or accessory I want with my PC or laptop.

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