Among the litany of complaints about the (un)usability of EMRs, it’s easy to lose sight of the big picture. More than the poor design choices and overall ugliness of existing software, by far the single biggest failure of HIT companies is that none of them has yet to produce an EMR that nurses actually need.
There is a huge opportunity being wasted here. Other industries have been able to incorporate computers in such a way that removing them from the workplace would be unthinkable. Photographers and musicians are producing high-quality content in less time and with less money in digital studios. Executives are monitoring every aspect of their businesses, from supply chain logistics to sales, in real time, even while on the go. President Obama made the Blackberry a non-negotiable component of his administration.
We’re not dreaming big enough. The intrinsic value of technology is it’s ability to provide solutions to problems we never knew we had. Remember having to tell the neighbor to get off the party line so you don’t miss an important call? Remember not being able to go out on the weekend because the banks don’t open until Monday and you have no cash? I don’t. A few bright minds solved these problems for me before I ever knew I had them.
Other than billing or records, what problems does an EMR really solve? In their current state, EMRs add nothing of value to our work as nurses. They are tedious chores at best, outright obstacles at worst. They are database portals where we type some numbers and check some boxes, and nothing more.
Meanwhile, our nation’s nurses continue to take and receive shift reports on folded up pieces of printer paper. They place bits of silk tape on door frames to remind them of pending lab draws. They sometimes give scheduled medications late because their iPhones don’t have EMR apps that might take advantage of iOS 4’s support for local notifications and beep them at the proper time. They lug around laptops bolted to enormous rolling carts or wait in line for a free desktop PC because they can’t chart their morning assessments on the iPod Touches in their pockets.
Nursing is a profession of the clock. It is task-oriented. It has a lot of routine. It consumes data as fast as it can produce it. In other words, it is exactly the kind of job that cries out for a technological revolution.