A Good Electronic Medical Record Does Not Make Up For A Bad Doctor

Efficiency is doing things right; effectiveness is doing the right things.

Peter Drucker

http://www.medpagetoday.com/PublicHealthPolicy/PracticeManagement/24503

It will always take four people to play a Mozart string quartet, no matter how fast microprocessor speed increases. Playing the music faster doesn't make it sound better. Taking care of patients is as much an art as a science, but the failure of Congress and others to appreciate this distinction may spell the doom of Obamacare, as well as many other reform efforts.

A physician must synthesize large amounts of information, but they also must interact with the sick on a very human level, mastering the subtle communication that characterizes the doctor/patient relationship. Care-givers know that a myriad of things are going on during any encounter, only some of which are related to science and medical knowledge. Knowing that a vaccination will prevent measles is far different than convincing a reluctant mother to let her one year old get a shot. Understanding that a course of chemotherapy with a 20% chance of cure may not be indicated in an 80 year old who has to take care of her arthritic husband cannot be done by computer.

Subtlety and complexity are the first casualties of a financial crisis. Obama and Congress have been assailed on all sides by the irreconcilable demands of pressure groups. Employers are losing competitiveness due to medical costs, Unions cannot meet their promises to their members, people cannot afford insurance, medical costs ruin families, millions are uninsured, medicare is going broke. Medical expenditures in America are the highest in the world, but our health and longevity are slipping.

It is no wonder our representatives have grasped for straws. Faced with such impossible choices, reformers have chosen to resort to the “magic” of technology. Electronic medical records have been anointed as the breakthrough solution to all that ails medical care. President Obama in his speeches continually evokes this panacea. A simple, cheap and universal fix for all of our problems would certainly be welcome, avoiding the hard choices and pain of other options.

The sad reality, as demonstrated in the referenced article, is that electronic medical records don't help very much. This is no secret to the doctor's using them, and I have discussed this several times previously(9/13/10, 11/7/10, 11/9/10). Electronic medical records do have some benefits, and eventually will be useful, but the added time taken to enter the data probably offsets any increased efficiency. Digitizing medical data is kind of like using your ipad to display the musical score. It is cool and saves turning the page, but it doesn't make you play any better.