The vast majority of the time, I believe that EMRs and medical software can help streamline processes if they are designed well.
However, the following is one of the few cases in which it seems to hurt rather than help.
Shooting a mosquito with a rocket launcher: An example from a neonatal intensive care unit (NICU).
I often go to medical IT conferences and hear people speak about their projects. One memorable talk was about a Neonatal Intensive Care Unit of 2 beds that decided to automate their patient charts. Now, neonatal ICUs have a ratio of anywhere from 1 RN per bed up to 3 RNs per bed.
Their original workflow involved putting up a (covered for patient privacy) chart on the wall (large poster size) with all of the relevant info about each baby. They could see all of the information at a glance. So, this would involve 2 charts for 3-6 nurses. These nurses work exclusively with babies in those 2 beds.
How can a computer system help them with their workflow to get it off of paper?
Answer: “it can’t”. After the baby has made it out of the unit, they should enter the relevant records into their Electronic Medical Record to record their information for future visits. However, at the point of care, they spent months designing multiple computer based flow sheets (chart pages) to “help” the nurses view the data.
During the presentation, they announced proudly that after all of their work, the electronic version was almost as good as the paper version.
Hmm… Not what I’d like to hear if my child was in the NICU…
