As EHR gets more refined, youll be fine

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If youre still baffled by unreadable, unusable EHR, hold on. The best is yet to come.


I just read a recent blog post by MD Karen Sibert lamenting how EHRs dehumanize the patient, providing only “endless lists” that don’t make any sense. This is a frequently heard complaint from providers, and I see it as “change talk,” indicating movement through stages of change.


Of course such a complaint ignores the many decades of completely unreadable, unusable, codified, and unsafe entries in paper charts. Perhaps Dr. Sibert has been lucky enough to work in settings where there is some uniformity of quality related to paper-charting. I sure haven’t. Certainly many providers can write an excellent note on paper. But even if that’s true for the majority, they’re completely obscured by the sub-par written notes so common in medical practice.


Of course electronic charting brings with it a new set of challenges and dangers. I’ve indeed seen electronic notes that make no sense, that are cut-and-pasted in ridiculous ways, that include every lab the patient has had in their entire lives, and have nothing in the assessment or plan.


But good EHR applications make that less and less common, making it easier to cut to the chase, get to the history, assessment, and plan, and make it easier to find those items for those who follow.


So hang in there, Dr. Sibert. I would say that you are currently on the cusp of the “preparation” and “action” phases of the Stages of Change scale, and as EHR gets more refined, you’ll be fine. And maybe more importantly, so will your patients.

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