IOM should study whether electronic medical records are worth perusing

LETTER — Posted Aug. 2, 2004

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Regarding "Doctors need to take a leading role on electronic medical records" (Editorial, July 5): I agree that EMRs are convenient, neat and a useful way of attempting to minimize medical errors as mandated by the Institute of Medicine.

However, as a family physician in a busy practice who has used two different systems over the past six years, I must point out that EMRs are not without their own sets of errors and problems. I would like the IOM to study whether updating all physician practices in America is truly worth the cost such an update will incur.

For example, when I fax prescriptions to pharmacies, I really need to be careful to proofread, or "#30 pills" could turn into "330 pills" (the # is above the 3 on the keyboard). If we are in a hurry, the prescription may be faxed to the wrong pharmacy. If we have two patients by the same name, the note may be been written on the wrong patient -- unless we are careful to examine date of birth during evaluation. Even then, if we don't catch it by the end of the day, the EMR signs off electronically on the note. Some EMRs complete sentences and prescriptions for you -- if not proofread, the computer may complete a prescription in a confusing way.

I challenge the IOM to investigate whether EMRs truly pay for themselves and aren't just the Game Boy of health care. I challenge them to find out whether EMRs ever become cost effective, when you look into the costs of initial set up, maintenance, etc. In the six years I have actively used EMRs, I must admit I enjoy using computers much more than I feel I truly benefit from their use.

Sigrid Johnson, MD, Sweetwater, Tenn.

Note: This item originally appeared at http://www.ama-assn.org/amednews/2004/08/02/edlt0802.htm.

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