Speed Reader ≠ Speed Scroller

It should be no secret by now that this rural family physician is pretty much unimpressed by today’s EMRs.

There are many little things that range from annoying to dangerous, but which don’t have a global impact on how I get through my day.

For example, in my Epic, the date when a blood test was ordered displays much more prominently than when it was actually drawn. This makes perfect sense for accountants, who keep track of when the order was received or when the bill went out. They have no idea that in medicine, it makes a difference whether the panic value reflects the patient’s status before they went to the emergency room last week or after they started their new potassium replacement.

More dangerous is when controlled substance prescriptions have an automatic stop date inserted if the provider follows the prompt and enters a numeric duration. What then happens is that a pain or anxiety patient who takes fewer pills some days when they feel better falls victim to having their medicine removed from their list on the day that is supposed to be the minimum time the drug is supposed to last, not the maximum (although Epic displays “up to X days”). Then, either my covering provider will refuse to refill a prescription because it is no longer on the patient’s list or that provider or I will need to re-create the medication from memory of another screen we have to visit, because you can’t “restart” an expired medicine in many EMRs. I have at least once prescribed the wrong potency of a pain pill that had fallen off the list. I caught myself because I had a funny feeling, and jumped through several hoops to retrieve the information from the old prescription.

But my absolute major gripe with today’s EMR’s is how much more difficult it is to glance at a report and get the gist of it. I don’t know if it is a generational thing, but I can glance at a report that follows the format of an 8 1/2 x 11” printed or faxed report and instantly get the essence of it and often even find the typos (for my readers outside this country, that’s approximately an A4 page). Even in my personal life, on my iPhone 13 mini, I can just take my myopic glasses off my nose and read a PDF of such a page and instantly understand what it means. Scrolling through screens that occupy maybe 20% of my laptop screen is slow and annoying and increases my screen time by many multiples.

Very seriously, if I get an emergency room report from my hospital, I only want to see the last page because that’s where the key information is. With the other hospital in the area, I only need to read the first page. But with an electronic medical record it’s not that easy to skip between the pages.

So, yours truly is a speed reader only if the page looks like a page. Maybe I should put up a poll: Page view or screen scroll preference by age?