In Pauline W. Chen, M.D.’s column, Doctor and Patient, this New York Times columnist explains the pluses and minuses of electronic medical records (EMRs).

They can change the way doctors and patients interact, depending on how the doctor uses the computer.

If your doctor already is a convert, you know what the effects have been.

For the rest of you, here is an idea of what doctors face in making this major change.

A diagnosis is, as much as anything, a story which has been taken apart by a doctor to find the problem. In this article, those surveyed said that that narrative thread can get lost, or, at the very least, interrupted.

The New York Times

…”This month, the Center for Studying Health System Change, a nonpartisan health policy research organization in Washington, released a study on the effects of EMR on physician communication. The researchers conducted in-depth interviews with the doctors and staff from 26 small and medium-sized practices across the country that used the electronic system in their offices for at least two years. Few, if any, of those interviewed would choose to revert to a paper-based records system. But all the physicians expressed concerns that EMR had less than salutary effects on the patient-doctor relationship, including difficulties replicating the narrative aspect of a patient’s illness and the constant interruptions from alerts and instant messaging. (Emphasis added)

“EMRs are a phenomenal contribution to care,” said Dr. Ann S. O’Malley, lead author of the study and a senior researcher at the center. But there is often so much information available — some of which requires a direct and immediate response from the physician — that “some doctors liken the presence of EMR to having a 2-year-old in the exam room.”

Source: New York Times, April 22, 2010

Citation: The Center for Studying Health System Change, Issue Brief No. 131