Clinical Scholar's TIME Magazine Piece Embraces Health Information Technologies, but Warns of Unintended Consequences
Electronic medical records (EMRs) and other health information technologies (HITs) are increasingly common in America’s health care system, and the federal government has begun investing heavily in them. But in a recent article in TIME Magazine, Zachary Meisel, M.D., a member of the 2008-2010 cohort of RWJF Clinical Scholars, embraces EMRs and HITs but warns of unintended consequences of the conversion.
Meisel offers an example:
[A] study conducted in Philadelphia demonstrated that computerized physician-order-entry systems facilitated medication-prescribing errors… [M]any of the problems arose from what are known as human-machine interface flaws. For example, doctors would sometimes assume that a display of standard doses were suggested doses specific to the patient being treated at that moment (not the same thing!). Or doctors sometimes picked the wrong medication or dose because they didn't know that all of their options did not fit on a single computer screen and that they could click through to a second screen for more choices.
And a personal example:
Not that long ago, if I ordered an X-ray on a patient, I had to walk into the radiology-reading area to look at it. Often there would be a radiologist sitting there in the dark room; we would talk about the patient in a way that would often lead to closer examination of one part of the X-ray. Sometimes this conversation would lead to a cooperative reconsideration of the findings. But now, unless I have a specific question or concern, I don't have to go back to the radiology reading room — HIT allows me to look at both the X-ray and the radiologist report almost instantly on my desktop computer in the ER. Sure, it is efficient and helps me see more patients and spend more time on other emergency tasks. But the result, I worry, is that I may be more likely to miss something important.
Meisel is not urging a scale-back of EMR use or use of other technological advances, but he calls for better planning to minimize such unintended consequences.