Time to rethink EMRs?

I am a family physician, Assistant Clinical Professor in the Faculty of Medicine at Memorial University of Newfoundland, and a Town Councillor in my home town of Torbay, Nfld. I have been privately advocating against the increasing push for electronic medical records (EMRs) by provincial and national medical associations for the past couple of years. I have written to both the Newfoundland and Labrador Medical Association and the Canadian Medical Association on numerous occasions, but one voice is not likely to change the minds of policy makers in our profession, and so I write this letter to ask for input from my colleagues.

I read a recent meta-analysis¹—one of my daily Canadian Medical Association POEMs (Patient-Oriented Evidence that Matters)—that highlighted recent research that showed the evidence for EMRs improving medical outcomes was very thin at best and likely nonexistent. We should be practising evidence-based medicine. Why are the organizations that represent us continuing to push EMRs?

My biggest issue with EMRs, other than that they do not help outcomes, is that they are likely deteriorating the physician-patient relationship. I say this because they are a distraction from the office visit, in that physicians are often spending more time looking at computer screens than at their patients. I recently had a patient move to my practice because his physician switched to an EMR and no longer looked at him during appointments, as the physician was so focused on the computer.

Electronic medical records are also excessively expensive, very time consuming, and complicated to set up and maintain. The country that has the most computerized medical system in the world is the United States. They also have an indebted, expensive medical system that, by all accounts and indicators, has far worse medical outcomes than most other industrialized nations do. One would hope that we could learn from our neighbour and not continue to waste our precious, scarce health care dollars on initiatives that have little benefit and potentially serious consequences.

I urge any physicians that share my worries about EMRs to relay these concerns to their local and national politicians and medical associations. Let’s get back to focusing our limited health care resources where they can have the biggest effect and practise evidence-based medicine. I appreciate you taking your precious time to consider the above perspective.