Electronic medical records: Ask physicians what they want

When medical practices and hospitals don't get physicians involved in the planning, purchase and implementation of an EMR, this promising technology is doomed to fail.

Editorial. April 7, 2003.

For many physicians, it would be unthinkable to work without such nontherapeutic but essential technologies as pagers and cellular phones. Someday most physicians might feel the same way about electronic medical records.

But for now, those technologies represent a digital divide. It is often most pronounced between younger and older physicians, the tech-savvy and the tech-skeptical, and those apt to see the technology's upside while minimizing the downside versus those questioning that technology can acknowledge the seemingly infinite vagaries of the patient-doctor interaction.

The EMR industry is still a nascent one, without technology standards, with products varying widely in price and quality, and with companies that aren't the household names that might bring skeptics some comfort. So until the perfect EMR arrives, installing a system will require not only computer knowledge but human engineering skills as well -- to bridge the "physician gap." Anyone installing a system, be it at a hospital or medical practice, must enlist -- and listen to -- the opinion of all physicians if this important technology can ever be expected to reach its potential.

That conclusion was borne out in a study published in the March/April Journal of the American Medical Informatics Assn. Studying the implementation of EMR at three hospitals, lead author Joan S. Ash, PhD, an associate professor of medical informatics at the School of Medicine at Oregon Health & Sciences University in Portland, found that all encountered physician resistance of some kind -- no surprises there. But the key to a successful implementation came when administrators listened to physicians' complaints and suggestions.