Article by Dharushana Muthulingam: “Patient R was in a hurry. I signed into my computer—or tried to. Recently, IT had us update to a new 14-digit password. Once in, I signed (different password) into the electronic medical record. I had already ordered routine lab tests, but R had new info. I pulled up a menu to add on an additional HIV viral load to capture early infection, which the standard antibody test might miss. R went to the lab to get his blood drawn
My last order did not print to the onsite laboratory. An observant nurse had seen the order and no tube. The patient had left without the viral load being drawn. I called the patient: could he come back?
Healthcare workers do not like the electronic health record (EHR), where they spend more time than with patients. Doctors hate it, as do nurse practitioners, nurses, pharmacists, and physical therapists. The National Academies of Science, Engineering and Medicine reports the EHR is a major contributor to clinician burnout. Patient experience is mixed, though the public is still concerned about privacy, errors, interoperability and access to their own records.
The EHR promised a lot: better accuracy, streamlined care, and patient-accessible records. In February 2009, the Obama administration passed the HITECH Act on this promise, investing $36 billion to scale up health information technology. No more deciphering bad handwriting for critical info. Efficiency and cost-savings could get more people into care. We imagined cancer and rare disease registries to research treatments. We wanted portable records accessible in an emergency. We wanted to rapidly identify the spread of highly contagious respiratory illnesses and other public health crises.
Why had the lofty ambition of health information, backed by enormous resources, failed so spectacularly?…(More)”.