I'll first say that I haven't read the full article, which frankly, is the same as most everyone who writes a comment.
The title and intro reminded me of this piece from the New Yorker a few months ago that written by a doctor and his experiences and others with the computers in the doctor field.
The summary is that health care, in the US and other countries too, is a giant system where even little changes take time to go through and become accepted. People who say there's an easy solution for electronic records are in no way correct.
It's a great read both in the information it gives, and also how good of a write the doctor is. I love his writing style.
I agree, not much more info than the New Yorker article.
Lots of anecdotes, but what I really care is: do outcomes improve or not? The computer can screw up, but so can the human, so which is better now?
Very US-centric too, other than the point about US doctor’s electronic notes being 3-4x as long as rest of world. Is the problem the EHR or the culture?
I don’t care about clicks. It’s more crude than using BMI for obesity. Replacing the mouse with a giant scroll wheel won’t improve things despite eliminating clicks. We use mice because they’re excellent human-machine interfaces for most users. (I like keyboard shortcuts, but you shouldn’t design for me).
How many minutes/seconds, or units of cognitive load, does it require to order that ibuprofen? And to get that ibuprofen to the from order to patient?
Are all of the clicks 10x10 pixel checkboxes on a 2 megapixel display?
Is it easy to do the right thing and hard to do the wrong thing?
What’s the full-cycle error rate of EHR vs paper requisition? And cost?
I noticed a lot of the complaints about "problems" with
the EHR is in reality mistakes made by humans that the software could theoretically have caught, like bad drug combinations, but it didn't either because the app just wasn't that smart, or because it generated alerts the humans ignored due to warnings overload (presumably itself caused by the risk of lawsuits).
This doesn't seem really like an issue with the software per se - paper can't catch mistakes in what you write on it.
I got the impression that people were complaining that such concerns are easily hidden in the confusion of the interface. With paper records, perhaps the hospital would have a system of making the summary page of the record (which is supposed to be updated before it gets put away) have important information about drug allergies, etc. In the EHR it may be 10 or 12 point text tucked into one line at the top or bottom of the screen and may not be visible on every page. Some physicians also have to deal with several different EHRs depending on where they're working on a given day.
Paper records are straightforward. You read through them completely and then go to work. If you don't do that, you're taking on a risk that you missed something important. EHRs can make that a little harder by obfuscating the history, only pulling up parts of the history at once, etc.
I think there's an interesting role to play for AI in creating useful, readable summaries of medical records that physicians can use. Probably too hard to get right to prevent accidentally censoring information that was important.
The title and intro reminded me of this piece from the New Yorker a few months ago that written by a doctor and his experiences and others with the computers in the doctor field.
HN discussion here: https://news.ycombinator.com/item?id=18381969
The summary is that health care, in the US and other countries too, is a giant system where even little changes take time to go through and become accepted. People who say there's an easy solution for electronic records are in no way correct.
It's a great read both in the information it gives, and also how good of a write the doctor is. I love his writing style.