Med student illustrates the horror of today’s EMRs

In a recent email conversation with a friend in med school I was once again reminded of the enormous unrealized potential of hospital IT systems (primarily EMRs).  Plenty of other authors and bloggers have described the politics, regulation, and lack of incentives on behalf of the major EMR companies that I believe have led to the current situation.  Rather than explain why this gap exists, I’ll just let this anecdote and perspective speak for itself.  This is the kind of stuff that energizes the innovator/entrepreneur in me.

Right now all the EMR’s are pretty terrible.  It is a constant battle to try and either get your patient’s on the right meds or keep them off the wrong meds.  Between all the residents, specialists, and different doctors that interact with a patient on a given day, one is bound to put them on a med that is contraindicated.  It happens every day.  Just tonight, I happened to be right next to the nurse as she took a call from the resident on call for a patient that was in liver failure and was requesting pain medication.  The resident told her to put him on Vicodin which has tylenol in it and is toxic for the liver.  I just happened to be standing there and told her not to do that.  But this stuff happens all the time, and I just happened to be around the patient.  The night before he was put on another liver toxic med by another doctor.

The whole system relies on people being right rather than a system of fail safes or an effective patient management system.  The EMR systems are just storage systems, they don’t have any smart features to them, which is such a shame, because we have all of this great information, but somehow medicine hasn’t found a way to organize it effectively.  Unfortunately, diagnoses get missed all the time, when the blood work screams the answer, but it is just missed by us.  Someone has to be working on this, right?  I certainly don’t have a solution for this, but I continue to find it an interesting question.