LETTERS TO THE EDITOR

Electronic medical records reduce patient's story

Kenneth S. Wayne, M.D., Clive

Excited to enter medical practice some 40 years ago, my colleagues and I dedicated ourselves to patient-centered health care. Talking to the patient was key to understanding their story and directing appropriate physical examination, diagnostic testing and establishing a rationale differential diagnosis and treatment plan.

Enter the new world order of government and payer-controlled health care mandates. The electronic medical record (EMR) has largely replaced the vital personal, individual and relevant written/dictated patient record, which served to preserve, present, communicate and follow the patient's story. The EMR, with its check boxes, copying, cutting, pasting features, and disease templates reduces the individual patient's story into a meaningless, incomprehensible, one- size-fits-all format.

This pretension of improved health care delivery is ideal for the regulators to monitor utilization and compliance parameters, evaluate mass population-based indicators of quality and safety, and provide the business office with the data they need for optimal coding and billing.

Unfortunately it undermines and devalues the physician-patient relationship to a strained and minimal interaction. Studies now document as much as 60 percent of physician time is spent on nurturing and fulfilling the mandatory EMR, drastically interfering with patient-focused attention. Meanwhile the politicians and third party payers can boast of the great new age of computer-centered health care.

— Kenneth S. Wayne, M.D., Clive