The introduction of the electronic medical records system into the practice of medicine has brought great benefits and presented great challenges to the doctor patient relationship.
Multiple studies have shown both benefits and detriments with EMRs. Benefits include a reduction in medication errors, which is the number one cause of adverse events,1 and fast access to important information about a patient’s medical history.2
EMRs, however, demand ever more provider time. This time comes at the expense of patients; as they are robbed of time available for direct interaction with providers.3 The negative workload impact of an EMR may, in fact outweigh the overall benefits an EMR has to offer.4
Further, it has become widely recognized that electronic information systems hold the potential to create unforeseen hazards for patients.5
It is the position of the American Academy of Emergency Medicine that:
- Emergency Department information systems (EDIS) should not harm the doctor patient relationship.
- EDIS should be subject to quality improvement review to ensure that they are not adversely impacting the doctor-patient experience.
- EDIS should be subject to regular safety reviews to identify potential patient issues such as communication failures, poor data displays, wrong order/patient mistakes, and alert fatigue.
- Any policy that requires emergency physicians to meet computer metrics must include appropriate measures to safeguard the integrity of patient care.
- Vendors and manufacturers have a duty to exercise due diligence in the development, sale and support of EHRs in order to ensure patient well-being. Accordingly, “hold harmless” and “learned intermediary” clauses in vendor contracts are inappropriate as they create a lack of accountability among vendors and unduly shift liability to doctors and nurses.
- Practicing EPs are the best judge of what suits the needs of their environment practice.
- Enterprise systems should be interoperable with ED specific systems as the latter may best serve the needs of the physician and their patients.