PookieMD's Blog: Where Physicians Learn About the Business of Medicine

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In my gig as Dr. EMR, I went to visit a hospital where they are using a version of the EMR my hospital will be transitioning to. It’s an EMR I am familiar with, and I wanted to see how the docs were coping. Rumor had it that it was rough going, with admissions and discharges taking up huge amounts of time. I wanted to see for myself and get the truth. I think what we are told is frequently very different than what is reality.

So, here is my reality check on what was really going on:

Doctors were treating notes in the EMR like a blank sheet of paper: forget all the templates available, the macros, the short cuts. They were doing what they always did, and that was to create a note from scratch. Down the drain went the huge power of the EMR, replaced solely by the inefficiency of typing everything.

Physicians were (remarkably!) resistance to change: I was not there on a training mission, but every once in a while couldn’t help but ask—“have you considered doing it this way?” or “did you know you could do this?” while demonstrating a nifty short cut. Many of the physicians would say, “But this is the way I’ve always done it.” (Always being relative—they’ve only had the *$%# EMR for 9 months!)

Physicians not using available hardware: the hospital had gone to a large expense to purchase dual monitors so that notes could be up on one monitor, while the physician looked at reports/labs etc. on the other monitor and added to their note. Many physicians never bothered to explore the benefits of the dual monitor, which would have made the whole note creation process easier. This is likely a combination of lack of training and well known physician hubris.

Conclusion: training, training and more training is necessary when adopting an EMR, but teaching an old doc new tricks may be darn near impossible! Woof!