The Broken Promise of Computers in Healthcare: A Doctor From the B.C. Era Explains

From 2022, one year before I started at Galileo

B.C., or “before computers”, medical charting was quick and information retrieval in small practices’ paper charts was effortless. Younger clinicians who never experienced well organized paper charts have been brainwashed to believe they were always chaotic and inadequate, perhaps like children born after the communist revolution in China… Oh, never mind.

With larger clinic sizes and with outside forces, like Medicare, Medicaid, insurance companies and middlemen, demanding more and more statistics, computers became the only recordkeeping modality that could deliver to all those “stakeholders”.

Clinicians like me were told that computers would make our charting, data retrieval and lives in general much easier. That was stressed more than the fact that all those people looking over our shoulders would have an easier time doing what they do.

For several years now, with the painful introduction and abandonment of one “new and improved” EMR and chaotic adoption of another even more complex one, I have had reason to think about how much longer it takes to do my work than it used to.

I posted once about how quickly I retrieved medication information from a handwritten medication list inside an old paper chart in my clinic. I have also written about how simply we entered INR values and Coumadin orders on paper flow sheets and how cumbersome it is in the EMR. To this day I have a (secret) reddish three ring binder with a flowsheet for each Coumadin patient I have.

I think I am particularly bitter about today’s EMR’s, their clumsiness and their intrusiveness because I was around before they came about (and happy with the paper charts) and because I was fed manipulative misinformation that they would make my life easier when the main purpose was to help the onlookers, the Wizards of Oz, the men behind the curtain and the ghosts in the exam room.

If you grow up with something that was there before you entered the picture, I don’t think you expect much more from it than what it is. But if you watch the introduction of it after listening to all the promises and then see how those promises were broken, you are more likely to be critical about its shortcomings.

But lest y’all think I’m an old Luddite who could never love a computer, or an EMR at that, let me tell you about the Saturday 5 years ago this month in Bucksport when I saw 27 walk-in patients in 7 hours, charted them all in eClinicalTouch on my iPad Mini and walked out the door 20 minutes after my last patient:

https://acountrydoctorwrites.blog/2017/10/14/driving-my-mini-ipad/