Doctors Push Back

This version of this article originally appeared in Computerworld's print edition.

Cost isn't the only reason why doctors may object to using electronic medical records systems.

Most commercial products in use today weren't built by clinicians, and some have faced doctor pushback. "Top-down efforts to create electronic health records often run into resistance" -- and even open rebellion among doctors, says Robert Smith, associate chief of staff for health care analysis at the Veterans Administration San Diego Health Care System.

Shaun Grannis, medical informatics researcher at the Regenstrief Institute, says the user interfaces in commercial products often lack flexibility and don't always present information the way doctors need to see it.

"In my electronic medical records system, it takes seven mouse clicks to place a prescription for my patients. That's too many," he says.

Grannis also would like to be able to view and change a patient's medications and diagnoses from the same screen, but the systems aren't flexible enough to allow that. He'd like to see a fully customizable, widget-style user interface like iGoogle's so a doctor could arrange different health information widgets and resize and reorder them on the same screen. "I'd like to decide how I'm going to interface with the system, not the other way around," he says.

Smith agrees that it may be less efficient to "mouse around" on electronic forms than it is to use paper. But if physicians can get over that, efficiencies in decision support and structured reviews of information such as lab and radiology results make electronic record systems worthwhile. The key, he says, is to tailor the systems to the physicians' needs.

Copyright © 2008 IDG Communications, Inc.

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