Time to rethink EMRs
====================

* Darren A. Hudson

Although I agree with most of Hall’s points,1 I fear he has drawn a false analogy. The United States Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 was enacted to mobilize information technology to reduce skyrocketing costs associated with the health care system.2

Hall1 states that the distracting effect of electronic medical records (EMRs) on the physician–patient interaction is well known. This is usually because of the usability of the EMR interface. Most systems are not designed for the patient encounter, and vendors are reluctant to customize their systems for physicians’ workflow. It is also well known that EMRs neither reduce health care costs nor increase efficiency. Poor usability decreases efficiency and frustrates the user.

The actual benefits of EMRs are likely unmeasurable. Recently, the American Medical Informatics Association has called for a re-evaluation of economic analyses in health information technology,3 with a focus on quality and patient-safety benefits. Electronic medical records can improve patient care even without cost reductions. I believe it would be a patient care disaster if we lost our provincial EMRs to save money.

Finally, I echo Hall’s comments about lobbying administrators and politicians about the use of EMRs. We are past the tipping point but, as an important user group, it is vital that we continue to loudly advocate for usable systems that will allow increased efficiencies and not diminish the patient–physician relationship.

## Footnotes

*   **Competing interests:** Darren Hudson is the associate medical director for the eCritical Alberta Critical Care Information System, and he has a masters degree in health information science from the University of Victoria, Victoria, BC, where he holds an academic post.

## References

1.  Hall T. Time to rethink EMRs. CMAJ 2015;187:602.
    
    [FREE Full Text](http://www.cmaj.ca/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiRlVMTCI7czoxMToiam91cm5hbENvZGUiO3M6NDoiY21haiI7czo1OiJyZXNpZCI7czo5OiIxODcvOC82MDIiO3M6NDoiYXRvbSI7czoyMzoiL2NtYWovMTg3LzExLzgyOC4yLmF0b20iO31zOjg6ImZyYWdtZW50IjtzOjA6IiI7fQ==) 

2.  Crownover K. Implications of the HITECH Act of 2009. Caring 2009;28:40–2.
    
    [PubMed](http://www.cmaj.ca/lookup/external-ref?access_num=19953864&link_type=MED&atom=%2Fcmaj%2F187%2F11%2F828.2.atom) 

3.  Riskin L, Koppel R, Riskin D. Re-examining health IT policy: What will it take to derive value from our investment? J Am Med Inform Assoc 2015;22:459–64.
    
    [CrossRef](http://www.cmaj.ca/lookup/external-ref?access_num=10.1136/amiajnl-2014-003065&link_type=DOI) 
    
    [PubMed](http://www.cmaj.ca/lookup/external-ref?access_num=25326600&link_type=MED&atom=%2Fcmaj%2F187%2F11%2F828.2.atom)