Patients have many legitimate gripes about the medical profession. Medical professionals have our own list of pesky frustrations. Overall, the profession is operating well, but there are well known deficiencies and flaws that are correctable and yet never seem to be addressed. This is a frustrating reality, particularly for physicians who are wired to improve and correct what can be fixed. Yes, the system is complex. Yes, there are competing stakeholders who are angling to protect their power and economic interests. Yes, despite an explosion of nurse practitioners and physicians’ assistants, patients still cannot obtain timely appointments. Yes, many medicines are too expensive even for folks who have insurance. Yes, medical bills are simpler than they used to be, but remain downright inscrutable for many of us. Yes, electronic medical record (EMR) systems are omnipresent, but why isn’t there a universal EMR so that allows any physician to access all of a patient’s records?
That last issue I raised above vexes me every day. For example, a patient might consult with his
primary physician (PCP) for an opinion on abdominal pain. Then concerned physician refers the patient
to the local emergency room (ER) for an in depth evaluation. Imaging studies and labs are done. The patient is sent home but is instructed to
consult expeditiously with a gastroenterologist. I, a gastroenterologist, then see the patient but may have no access or partial access to
any of the medical records from the PCP or ER.
Please explain to me how this makes sense or promotes high quality
medicine. The absurdity also exists in reverse. If one my my patients proceeds to an ER with
digestive issues, the ER may have no access to my records.
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Indeed, when EMR came onto the medical scene, it offered the promise of connectivity among the various EMR versions. Physicians like me salivated that we would overcome the formidable obstacles of separate medical records silos that existed during the paper chart era. This promise has not been kept.
As artificial intelligence is about to explode and replace
all of us, are we expected to believe that a universal EMR system is beyond our
reach? More accurately, the constituency
that wants it the most – medical professionals – does not have the pull to force
a solution.
As someone who's worked in informatics for years I can tell you real problem with EMRs are that the patient and the doctor are not the customer. The "customer" are the hospital systems, the government, etc. Other wildly successful apps have the customer focus in mind since if they don't work for you, would not use them. If Uber, DoorDash, Chase, Bank of America, etc, etc had apps as onerous as even the best EMRs we would not use them. Unfortunately, thats not the case for our EMRs.
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