The electronic health-record process, including computerized physician order entry, is still slower than the pen.
EHRs, CPOE 'still slower than the pen'
Although I have been using an EHR in one form or another since 1991, the problems remain essentially unchanged. The doctor is the rate-limiting step in the documentation process, and the documentation process is the rate-limiting step in the doctor's workflow.
When the requirement is for extensive documentation in a full EHR for instance, the scribe facilitates parallel workflow, documentation processing and therefore shortens the overall process.
Until new innovations in graphical user interface allows for documentation to be as facile and therefore attractive to clinicians as the pen, then resistance will continue (e.g., path of least resistance).
Furthermore, most of the benefit of digital documentation will continue to accrue primarily at a higher aggregate (e.g., insurers, researchers, government, etc.) rather than on the individual provider level. This lack of overwhelming individual workflow or economic benefit will continue to stymie rapid adoption.
This is not to say that the process should not continue to move forward at breakneck speed.
Rather, we should not be so quick to dismiss facilitative processes that enhance the workflow, improve doctor's acceptance and in reality may be quite necessary to pragmatically implement an imperfect technology.
Duane F. WiskPrincipalDigital DOTGrand Rapids, Mich.
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