'So Tell Me What You Want, What You Really, Really Want.'

“Wannabe”, by the Spice Girls, speaks about female empowerment. Released in 1996, it subsequently became the best-selling single from a girl group in the world. Astonishingly, it was written in 30 minutes and recorded in under an hour. This happened because the group knew what they wanted. It also helped that they had most of the song’s content beforehand, except for the “zigazig-ah” part.

Clinicians are not known for their pop songs, although a hit single could very well help to propagate what they really, really want. Fortunately, we don’t have to go that far. One commentary is that EMRs remove the soul of the Medical Record ⁽¹⁾. Instead of creating more time for patients to spend with their doctors, there is a push to see patients more quickly. EMRs should automate the business of medicine and not the art of medicine. They should stay away from the exam room! They should not prescribe how the doctor patient engagement must happen, rather they should support that interaction. Let the EMR be a secretary. Collate and bind everything into a patient book. Make it easy to flip pages. And nicely stated “…do learn from beautifully maintained old paper charts. Go out and look at some before they are extinct. You can’t improve that which you don’t know.”

Another article discussed a reported study of 17,500 physicians in the US and summarised what they wanted ⁽²⁾. The results have a slight bias towards reimbursement, so may not completely apply to all healthcare jurisdictions. Nevertheless, the top 5 went like this:

1.  Documenting a Chart Note Quickly

2.  Going Paperless

3. Increasing Reimbursements

4. Dealing with a Financially Stable Company
5. Improving patient care

Simple really, right? And the bottom 5:

1.  Interoperability

2.  Assisting with HIPAA Compliance

3.  Providing Decision Support

4.  Providing Disease Management

5.  Having A Patient Portal

There is a clear message that EMRs need to “bring the focus of medicine back to patient care”. It shows that a disparity exists between the clinical needs versus the functions provided by EMRs. As the author notes, a probable cause for EMR failures. If the basics are not catered for, the bells and whistles are a painful reminder of paradise lost.

There is a strong desire for an EMR that can offer a traditional yet classic approach, with the paperless bells and whistles. That which allows clinicians to deliver and record the care, without the clinician needing to care about the delivery of the medical record – the EMR takes care of that part.

So tell me what you want, what you really, really want; “I wanna really, really, really wanna zigazig-ah”. Some more “zigazig-ah”; the same, only much better… more “zigazig-ah”… more clinical empowerment.

(1) http://www.kevinmd.com/blog/2014/11/emrs-remove-soul-medical-record-whats-next.html

(2) http://www.emrconsultant.com/emr-education-center/meaningful-use/ehr-success-and-failure-in-the-hitech-age/