Joel Diamond 11/19/10

Shut Up and Get Your EMR Already!

I don’t mean to sound so superior, but it’s enough with the whining already. Forget the early adopter thing. It’s been 10 years since I put an EMR into practice. 10 YEARS!!! Way before Meaningful Use and widespread broadband, we showed a return on investment, improved efficiencies, and better patient outcomes due to this technology. Yet I still must endure colleagues constant complaining about how difficult it is to adopt computers in their professional lives. 

So pardon my attitude today, but come on … my 80-year-old mother has a Facebook page and regularly communicates with her seven-year-old grandson using Skype. Did you ever see the TV ads for the motorized wheelchair, Hoveround (“you can go, go, go in your Hoveround”)? I hear the new versions will have GPS and WiFi. Please tell me that doctors “just aren’t ready for technology in their lives”.

And also don’t continue the old line that EMRs are “disruptive technology”. I’ll buy an argument that they are just not cool or dangerous enough. The “disruptive” argument doesn’t apply to things like … lasers. Think about it, like Dr. Evil in Austin Powers (“I didn’t go to six years of Evil Medical School to be called ‘Mr.’ thank you very much”) most doctors want “frickin’ lasers” everywhere.

Its true — there are papers written on how to reduce a one-inch carpal tunnel incision to ¾ inch using laparoscopic technique. In fact, I’ll bet you’d get a standing ovation at Grand Rounds for demonstrating how you lanced an ass pimple with a laser, compared to the yawns resulting from a presentation on how Information Technology saves lives.

I guess I shouldn’t be too harsh. After all, I am sure that it must be difficult for docs to employ this obtrusive technology while downloading the latest Angry Birds and iFart apps on their phones.

Speaking of iPhones, here’s one of my favorite lame excuses: I’m waiting for an EMR that will work exclusively on my smart phone. Yeah right. I’m sure your patients will be convinced that you are actually comparing trends in their complex laboratory values while your Flo Rida “Who Dat Girl” ring-tone is blasting in the background.

Here are some of my other favorite excuses (it’s best to read out loud with a nasal-whining voice):

• I’m concerned about hackers. This from a group of people that routinely purchase with credit cards over the Internet, trade stocks online, download music and (um)… movies… from untrusted sites.
• It’s too many clicks. Remember, people used to make this same argument about newfangled “word processors” compared to the good old-fashioned typewriter. Just stop sometime time and count the number of steps involved in manual routine tasks that we accept as normal.
• I’m not sure my patients would like me staring at a screen. No doubt. I’m sure that your patients feel the same about their banker’s preference of a computer over a handwritten ledger, and I’m so sorry that your only two choices are paper charts or an incredibly bad bedside manner.
• And (drum roll, please), my all-time favorite excuse: Patients will die! This is doctors’ trump card when talking to administrators and IT professionals. I heard this multiple times when our hospital turned off paper lab feeds in favor of electronic versions. That, too was many years ago. No one has expired as a result yet.

Come on… please… it’s enough already.

 

Joel Diamond, MD is chief medical officer at dbMotion, adjunct associate professor at the Department of Biomedical Informatics at the University of Pittsburgh, and a practicing physician at UPMC and of the Handelsman Family Practice in Pittsburgh, PA. He also blogs on interoperability.