EMRs: Stop Complaining and Start Asking Why Not

Quick, name the Centers for Disease Control (CDC) criteria for strep pharyngitis.

That next patient you see, tell me when their last labs were done, what health maintenance they are due for or have already done, what their medication list is, what their chronic problems are, allergies, and when you last saw them and for what.

Next give me a list of all your diabetic patients, when they were last seen, their last HgA1C, and their last lipids and blood pressure.

You can’t do that?

Why not, doctor, it’s all there in your chart or your brain, right? But what help do we need?

Why, yes, it is all their in their chart and the electronic medical record (EMR) that you’re using. You have to click multiple times or flip through a three-inch thick paper chart to see it?

When you see someone for pharyngitis, the EMR you’re using doesn’t automatically calculate the CDC score for the likelihood of strep pharyngitis based on how you complete the visit note?

You can’t print out a list of patients with selected diseases and their latest lab reports, or maybe even just the ones you haven’t seen for one year?

For those who have an EMR that does this, please let me know what you’re using. For those who don’t, why doesn’t it?

For all the critics of EMRs, the non-believers, the laggards, the “it’s too expensive,” “too slow,” you should be asking for these things every day. Imagine how much more efficiently you could see patients if you had these abilities, easily and quickly.

Imagine if your EMR could take the history from the dizzy patient without you being in the room. You know, the history that takes forever, but that has the critical details from which you can usually make the diagnosis.

All these things are possible, and available, right now. But you have to ask and to imagine what you would like to do better, faster, and more easily than now.

Stop complaining and start asking why not.

Are you happy with your EMR? What would you like it to do? What about it makes you happiest? Drives you crazy? Are you a laggard?

Why?

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