The Pitfalls of Electronic Medical Records
Patient-doctor relationships move toward more record keeping, less patient care.
Posted Nov 10, 2014
I had reason to look online at my electronic medical records recently. The errors were shocking and misleading. Getting them corrected isn’t so simple either. Is your doctor “in” and paying attention when you visit? Or, is he or she pecking the keys on a computer while you talk? Medicine is moving to more record keeping, less patient care—at least it seems that way even among physicians who are reluctant computer users.
In her New York Times article, “With Electronic Medical Records, Doctors Read When They Should Talk” Dr. Abigail Zuger calls medical data management a “crisis.” She refers to sending Thomas Eric Duncan home with deadly Ebola as “last month’s debacle in a Dallas emergency room.” The article reminded me of my own medical records experiences and how easy it is to be misrepresented and misdiagnosed in the information that repeats itself over and over with every office visit—that’s how my records look. Your records could look similar.
My initial encounter with electronic medical recordkeeping by physicians was about five years ago with a doctor I had been seeing annually for over 20 years. He arrived in the examining room pushing a cart with a laptop computer on its tabletop. He got comfortable and started entering my answers. I stopped to ask why he, not one of his competent nurses, was recording commonplace information such as birth date, number of pregnancies, parents’ medical history and so forth. His answer: “I want to be sure the information in my records is correct. If I put it in, I know it will be. If one of my nurses does it, I’m not so sure.”
Some doctors do not like electronic medical records, yet more and more of them have no choice but to use them. Patients compete with the computer for the doctor’s attention; doctors cannot be fully engaged with the patient while focused on typing.
In response to Dr. Zuger’s article, another physician wrote, “I am reminded of the advice given to medical students by Dr. William Osler, a master diagnostician who practiced long before the era of modern technology: ‘Doctor, listen to your patient – he is telling you the diagnosis.’”
The Pitfalls of Electronic Medical Records
One doctor told me, “the records are great for insurance companies in terms of paying claims, but they don’t give me a true picture of what is going on with patients—electronic record keeping diminishes my ability to focus on my patients. I prefer to look at them when they answer my questions. That way I can get a better sense of how they are feeling.” Others had similar reactions.
A few weeks ago, I had reason to look at my records from a new primary care doctor’s office that makes its records available online to patients. Convenient? Yes. Accurate? Not even close. Note: This is a highly reputable primary care group affiliated with a top-notch teaching hospital. I believe the group represents the pitfalls of electronic records in medical practices nationally. He and the colleagues who cover for him type away as I describe a symptom or offer relevant pieces of information. My records were appallingly incorrect.
Two examples: What I announced as a symptom was recorded as “patient denies having…” which had been true during a previous visit, but not that one. Further, the records for every visit all read: “Cancer-Active.” Maybe that’s code for something, but I had cancer 26 years ago with a full recovery and no recurrence. “Cancer-Active” shows up on the pages for each visit, as does every other inaccuracy. When I requested a change, I was told corrections could not be made to previous entries.
The state of my online medical records makes me feel as if many doctors are not “in” anymore, never fully present to hear and process symptoms or complaints, to analyze what might be affecting or causing a patient’s condition. If they missed something, they go with whatever was in the previous record.
Have you asked to see your or your children’s medical records? If you haven’t been able to access them online, perhaps you should ask how you can. Please share your experiences or what you discover in the comment section.
Physicians weigh in: Electronic Medical Records, Built For Efficiency, Often Backfire
Wainapel, Stanley F. MD. “Listening to Patients” (Letters to the Editor). New York Times, October 21, 2014, p. D3.
Zuger, Abigail. “Repeating the Mistakes of History.” New York Times, October 14, 2014, p. D1.
Copyright @ 2014 by Susan Newman
· Sign up for Dr. Newman's monthly Family Life Alert Newsletter
· Visit Susan's website: www.susannewmanphd.com
· See Susan’s latest book: Little Things Long Remembered: Making Your Children Feel Special Every Day
Photo credit: FreeDigitalPhotos.net