It is not so much that all Electronic Medical Records are terrible, but rather that it is so close to true that the occasional net-positive EMR roll-out does not move the needle much on its own. The greater challenge is that the reasons why the EMR experience is so poor also make it unlikely that EMRs will get dramatically better in the short-term.
The root of the EMR problem, fundamental to their very nature, ensures that EMRs will get worse before they get better.
I'm yet to be impressed by a hospital-wide monolithic EMR – one that is intuitive to use, enhances safety and reduces clinician workload rather than adding to it. An EMR that offloads administrative burden from healthcare providers, and enhances authentic interactions with patients. Where are the truly efficient EMRs that are true improvements to the paper-based systems they replace?
“Show me an [EMR that] only triples my work and I will kiss [their] feet.” – House of God1
Many EMRs are frustrating and inefficient, though tolerable in a necessary-evil kind of way. Clinicians put up with the many small EMR-inflicted aggravations because of the promises made for improved safety, efficiency and lowered costs. Yet the modern EMRs of today have largely failed to live up to even these low-bar aspirations.2
I use ‘EMR’ (Electronic Medical Record) in the strictest sense here, meaning a system for managing medical records in a hospital or group of hospitals. In North America ‘EMR’ is sometimes used interchangeably with ‘EHR’ (Electronic Health Record) which is more accurately a population-wide record of health, such as Australia’s imperilled My Health Record. In this example the EHR is an aggregator of health summaries, not a hospital medical record. At a medical-practice level, it is more accurate to talk about ‘practice management software’ than EMRs. ↩