Human Factors in the EMR

Anne Armstrong-Coben, an assistant clinical professor of pediatrics at Columbia, has an op-ed in today's New York Times in which she worries about the downside of electronic medical records (EMRs):

Doctors in every specialty struggle daily to figure out a way to keep the computer from interfering with what should be going on in the exam room — making that crucial connection between doctor and patient. I find myself apologizing often, as I stare at a series of questions and boxes to be clicked on the screen and try to adapt them to the patient sitting before me. I am forced to bring up questions in the order they appear, to ask the parents of a laughing 2-year-old if she is “in pain,” and to restrain my potty mouth when the computer malfunctions or the screen locks up. I advise teenagers to limit computer time as I sit before one myself for hours each day until my own eyes twitch and my neck starts to spasm.

In short, the computer depersonalizes medicine. It ignores nuances that we do not measure but clearly influence care.

As we begin to formulate our strategy for effectively implementing an EMR system at CCHS, we must pay as much attention to the usability of the software -- the human factors that will utltimately determine its success or failure -- as we do to the medical and technical requirements.