EHR sent this physician back to efficiency of handwritten records

Regarding "EHRs must be made irresistible, but for now are clearly inadequate" (Letters, May 26): I am one of those doctors mentioned by letter writer Christine A. Sinsky, MD, of Dubuque, Iowa, who has the staff reprint much of the medical record for each visit. Then each day, I have my staff scan my handwritten record back into the computer.

I was so glad that Dr. Sinsky has put my feelings into print that one screen at a time, the electronic health records disrupt thought flow and inhibit data synthesizing. The EHR was implemented into this large ophthalmology practice in 2005, and I gave it a year to find out how much it slowed me down, which was about 50%.

My frustration level rose to the point that my staff suggested to me the paper work-around method, and since then I have been much happier.

I cannot remember all the data on every screen, so I had to go back and forth, shift windows, take notes, hunt in frustration to find items others have filed away, and correct macros that the computer automatically puts in when you check boxes. Drawing with a mouse is slow and inaccurate, and the pictures were in another file.

I read the constant litany from politicians, administrators and financial people that doctors should embrace this overpaid file clerk in the name of medical excellence. But in reality, it is yet another hurdle standing between me and my patient, and an accurate record of what really happened at the doctor-patient encounter. And yet there is silence from the doctors who are finding these systems to be of little more use to them than legibility at the price of terrible redundancy and time inefficiency.

There is little written about the continuous upward learning curve needed to operate these programs, the endless infusion of money into their upkeep, and the very loss of privacy these records create. The electronic health record is not ready for prime time, and certainly is not to the place where its use can be legislated.

This emperor on parade has no clothes on, and I think that we children along the roadway need to say so clearly.

John M. Mezoff, MD, Gallup, N.M.

Note: This item originally appeared at http://www.ama-assn.org/amednews/2008/06/23/edlt0623.htm.