leswp1
New member
The downfall of any EHR is the data, and any time we move from one system to another - in any industry - data is lost. In healthcare, the data is "owned" by the operational groups/management and not by IT. We - IT folks - inform the operational folks of this constantly, and in the case of system migrations, what those same ops folks need to do. And they almost never dedicate sufficient resources to it.
Data migration is hard and important, so people simply don't do it. Especially when they can simply blame this nebulous "IT" thing to patients.
And you know what? It's still a thousand times better than paper.
edit: that said, it's super super frustrating when you're on the short end of the stick.
Data that needs to be mined is transferable. If it doesn't fit into a little box then many times free text is the only way to document. Free text does not migrate.
This was simple demographic info that didn't migrate.
In the last few months have seen a couple of large studies showing there is no benefit to efficiency, patient outcomes, shown from using EMR vs paper or other non-EMR systems. Anyone who has used a good system pre-EMR has no surprise for this. People who have no experience before EMR have no idea how much more efficient it was to document.
It was in my medical journal stuff. Of course I can't find it now when I went looking for the link. SYnopsis- There was no statistical improvement using EMR and in some cases older systems were more efficient and less prone to error. They looked at pt outcomes, efficiency, timeliness and ability to find information (I think those were the parameters but I can't remember)
EMR inefficiency, ability for info to be entered in places where it could be missed, ability to create and perpetuate errors by copy/paste/ repopulate, the loss or 'corruption' of data as it was migrated from system to system were some of the things they noted. They also noted the EMR was initially created to be able to mine data for insurance companies and the structure remains focused on data mining so no matter how inefficient, confining in ways to convey information, it will not change.
The commentary after the article was fascinating. Those of us who learned to practice real medicine (not driven by insurance) and wrote/dictated notes rich with details about the patient were on one side. Those trained to consider insurance parameters and EMR templated notes on the other. Eye eye opening to see how much knowledge has been lost and how patients were viewed more as objects when you just click a button. Some of the stories people told about how really important stuff was missed -there was no place for it in the chart or it was in there and not accessible unless you looked really hard for it.
It isn't IT fault. There is no way in heaven I am going to be able to click a little box to tell the story about someone's suicidal ideation, family issues, past trauma, weird sign or symptom and get more than the category across. Every time I saw a patient with only EMR records I had to basically start again to get the real story.
Still hunting for the link.
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