Doctors don’t often make a mistake about how many feet their patients have. Unfortunately one young doctor did make this mistake after relying too heavily on an erroneous electronic medical record.
An intern at a hospital reported to the attending physician that the patient in question was “status post below the knee amputation” (BKA) which had been noted on each of the patient’s prior three discharge notes.
After seeing the patient, both the intern and attending doctor were extremely surprised the patient had both legs, both feet and all ten toes. It turned out that four hospitalizations ago, the voice recognition dictation system had misunderstood diabetic ketoacidosis (DKA) as BKA and none of the physicians who reviewed the chart had detected the error.
Luckily this error could be easily corrected.
However, the intern’s mistake highlights a growing problem with government-mandated electronic medical records. Doctors are spending more time in front of computer screens and less time with their patients. This affects how doctors interact with patients.
The Health Information Technology for Economic and Clinical Health Act (HITECH) of 2009 mandates that physicians and hospitals adopt electronic records by 2014. If they refuse to do so, they face penalties in the form of reduced Medicare/Medicaid payments.
Adopting electronic medical records seems like a no-brainer for doctors and hospitals. After all, electronic records are the norm for many successful businesses. Theoretically electronic medical records should help doctors to be more efficient, however it has been proven that doctors are finding electronic medical records to hinder their ability to practice good medicine.
A recent study from Northwestern University found that physicians with electronic medical records in their exam rooms spend an exorbitant amount of time looking at computer screens compared to physicians who use paper charts who spend about 9% of their time looking at the charts.
Physicians who are too preoccupied with looking at a computer lose some of their ability to listen, problem solve and think creatively.
According to a New York Times health writer, doctors are so busy filing out electronic forms that they only spend 8 minutes per patient a day.
Electronic Medical Records don’t eliminate medical errors; they only change the kinds of errors that are made.
They eliminate the problem of doctors’ illegible handwriting on prescriptions, but instead the problem arises that sometimes physicians accidentally click on the wrong medication on the menu.
Electronic Medical Records can be powerful tools when designed properly and use wisely.