A January 8 story in The New York Times shone a bright light on the perils of implementation for electronic health records. “The report was critical of the lack of guidelines around the widely used copy-and-past function…available in many of the largest EHR systems. The technique…can reduce the time a doctor spends inputting patient data. But it can also be used to indicate more extensive – and expensive – patient exams or treatments than actually occurred.” The report found that three-quarters of hospitals have no policy on cut-and-paste, which opens the door to “potential fraud and abuse” in the 44% of US hospitals that have installed EHR systems.
Let’s not blame the healers. A different study found that emergency-room physicians in a community hospital spent 43 percent of their time entering data, clicking up to 4,000 times during a 10-hour shift. No wonder they are cutting-and-pasting like mad, just to make time to care for their patients.
If blame there must be, let’s put it where it belongs: on the “let’s all jump off the cliff at the same time” mentality that has driven the EHR roll-out. For decades, modern medicine has run on paper files. What sense does it make to attempt an instant conversion that forces that information overnight into hundreds of fields in dozens of screens?
What medical professionals need is back-up: the ability to access that document-based information within the EHR system. When EHR includes digital documents accessed through a workflow system, a lot of the problems will go away.
And while we are speaking of problems, here’s a question. Why are all the headlines about money? Cut-and-paste may open the door to fraud – but it definitely opens the door to the entry of incorrect patient information. Given the right situation, bad data can lead to a bad diagnosis and the wrong treatment. Of course money matters, even when health and human lives are on the line. But it is not the most important thing on the priority list.
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Read “Report Finds More Flaws in Digitizing Patient Files” at www.nytimes.com