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26
| Greater Kansas md news
��� mdnews.com
E
Ven The mosT avid supporters of EMR technology acknowledge its potential
for frustration. A 2007 paper in the Journal of the American Medical Informatics
Association titled, ���Unintended Consequences of Information Technologies
in Healthcare,��� by Michael Harrison et al. has proven prophetic, based on
the many voices of frustrated physicians. While vendors promise technical bliss
and federal regulations mandate meaningful use, the paper���s authors locate EMR���s
���make it or break it��� points in the human behavior that translates ��� or fails to
translate ��� technology into outcomes.
As an example, the authors describe clinical experts who object to fixed-choice
templates in EMRs. The physicians preserve their autonomy by writing their
diagnoses and orders as personalized notes in the free-text field, thus avoiding the
decision-support functions.
In other words, the EMR and those who purchased and installed it had one
agenda; the physicians had another. The result was a work-around that foiled many
of the EMR functions, such as decision support, and probably reduced the extra
