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Computers in medicine — better than the stethoscope

Posted April 04, 2011, at 9:26 p.m.
Last modified April 06, 2011, at 5:28 a.m.

Forgive your physicians if they are looking more and more like your computer-addicted teenager these days, because there’s a darn good reason; computers are the best thing to come along in patient care since the blood-sucking leech. In fact, if you now made me choose between my stethoscope and my computer, I would take the computer.

That’s not because microchip aliens from Microsoft have taken over my brain. It’s because the computers I use now include the electronic medical records, EMRs, of patients I am treating, and a vast array of other computer-based help for our collective efforts to take care of them.

And I need all the help I can get. There must be at least 15 things I should remember to do for every patient I see, and I could not remember all of them every time even if I knew what every one of those things was, which I don’t. My computer with its EMR can tell me that about each of my patients with one click of the right button. I cannot remember the interactions between thousands of medicines I might prescribe for you, but the computer can.

Beyond all of that, a properly used EMR can help reduce the ordering of duplicative tests, help connect your physician with others taking care of you, put best practice guideline information at your physician’s fingertips, and allow you to have constant access to your medical record from anywhere.

It can do all of this because a good EMR brings together two of the computer’s greatest capabilities: the ability to organize and store vast amounts of information, and the ability to access that information in a heartbeat. What if, for example, you are a diabetic patient seeing me in the office and we both want to know how your diabetes care at that time compares to the best care? With a few clicks of the computer mouse on buttons in your EMR chart, we can have the information and know what we both need to do to fill in the gaps between your care and best care.

Want to be able to see how my care of all of my diabetic patients compares to those best practice standards? Some more clicks, some more microchip voodoo, and voila — the computer wizards can tell me about all of my diabetic patients and which ones need what. That way I can arrange fewer visits for diabetic patients who are doing well, and more frequent appointments for diabetic patients whose disease is out of control and slowly destroying their health.

EMRs can allow teams of caregivers to share patient information. That enables coordination and cross-checking of patients’ care in ways that were never possible when patient information lived in separate silos of patient information in paper charts.

Now, maybe your physician, nurse practitioner, or physician assistant is lots better at coordinating care and remembering all of this, so does not need an EMR, but I doubt it. The fact that study after study says physicians and other health care providers don’t do nearly as good a job taking care of patients in ways that medical science says are the best ways suggests they need the same help I do. That and other reasons are why implementation of EMRs in hospitals and physician offices is sweeping the country.

There are downsides to the EMR, of course. If my physician spends all of his time looking at the computer and typing away instead of talking to me, it may feel like the computer has come between us. EMRs are expensive, can make providers less efficient, and are only as good as the information human beings put into them. They have yet to deliver on their potential to improve care and reduce costs.

The path between the EMR and better, more cost-effective patient care is not a straight line, but a twisting journey over bumpy road. But it’s the right road for us all, and if your physicians aren’t on it, remind them of all the times they urged you to do the difficult things required for improving your health, and then tell them “Heal thyself.”

Erik Steele, D.O., a physician in Bangor, is chief medical officer of Eastern Maine Healthcare Systems.

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