June 10th, 2010

Electronic Health Records: Not All About the Machine

Coverage from the recent Medical Library Association meeting included a lot about electronic health records (EHRs) such as the EBSCO Sunrise Seminar, my coverage of the Linking E-Resources to Clinical Information Systems (CIS) session and a panel on Wednesday.

I am sorry I missed Dr. John Halamka’s (Life as a Healthcare CIO) presentation of the Leiter Lecture at the National Library of Medicine and am looking forward to finally having a chance to catch up with his video and slides this weekend. One does not mess with the timing of the only nonstop flight from Washington DC to Seattle though, there were cancellations of connecting flights through Chicago that stranded some of my Seattle colleagues!

Other perspectives that have my attention are The ADL Librarian who started a series about The Role of Libraries in EHR Implementation beginning with Challenges, especially from the perspective of primary care who may not already have relationships with medical librarians, and Dr. Jeff Belden featured the recent AHRQ white paper addressing EMR usability: Vendor Practices & Perspectives which cannot be overlooked.

Of particular interest to me was when Dr. Edward Pullen wrote about How to talk to patients with an EMR in the room on KevinMD though. I recently had the opportunity to see a new doctor who followed these six recommendations extremely well. He maintained a near constant verbal contact with me as he explained what notes he was entering in the EMR, why, and which parts of the notes would integrate with a standard template patient after-visit printout which resulted in it being the best one I’ve received and I’ve had an EMR through this HMO since 2001.

It is due to a combination of this experience and Harborview Medical Center being local that I’ll be following the progress of the recently announced OpenNotes study of over 100 physicians and 25,000 patients funded by the Robert Wood Johnson Foundation to evaluate the impact on both patients and physicians of sharing, through online medical record portals, the comments and observations made by physicians after each patient encounter with great interest. From the press release,

“Doctors have strong differences of opinion about giving patients access to their notes. However, the debate is largely uninformed by evidence,” says Stephen Downs, assistant vice president at RWJF and member of the Foundation’s Pioneer Portfolio. “In the context of a physician’s day-to-day work, opening up notes is a subtle change—but it could reposition notes to be for the patient instead of about the patient, which might have a powerful impact on the doctor-patient relationship and, in the long run, lead to better care.”

They’ve got that one right if I as a medical librarian with both an interest in health informatics and 9 years of experience having an EMR was impressed with the inclusion of personalized notes in my after-visit patient handout.

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2 Responses to “Electronic Health Records: Not All About the Machine”

  1. […] This post was mentioned on Twitter by Nikki D., Steve Downs and Adam Coyne, RWJF Pioneer. RWJF Pioneer said: RT @eagledawg: EHRs are not all about the machine: medlibs, usability & the OpenNotes study w/my story http://bit.ly/djOlWZ […]

  2. […] Dettmar presents two posts on Electronic Health Records at Eagledawg.net, inspired by a recent Medical Library Association meeting that included a lot […]

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