I don't use electronic medical records (EMR). Let me qualify that: I don't use EMRs for when I write notes on patient visits; I do use online patient scheduling, I read laboratory studies online, and I do write orders for patients in the hospital online. But most of the notes I write on patients are on paper. (Although they're
highly personalized templates, which increases efficiency and allows me to care for patients better.)
And I'm not alone.
Only about 25% of doctors use EMRs. The reasons are varied, but many physicians do not want to invest in a proprietary system with uncertain benefits when paper has served them well for decades. (Google, in particular, is working on a
free interoperable medical record system for patients and doctors which tackles these problems.)
EMRs definitely have advantages, one of which is instant access to patient records at crucial moments -- such as when a patient is admitted to the hospital or calls on the phone with an urgent problem. In these situations, it's helpful to have a recent medical history, labs, and a list of medications close at hand.
I've lately explored options of digitizing paper medical records. None of these are real solutions, of course, but they do suggest ways of forming a makeshift bridge between the paper and electronic world. (These solutions might be used by both providers and patients to make paper medical records more accessible electronically.)
I've previously written a three part series on medical uses of the iPhone (
1,
2 &
3). Recently, there was a patient that I had seen in the office whose records I knew I would need to refer to in the hospital. I contemplated copying the records and bringing them along, but then I realized that I could just photograph them with the iPhone's camera and review them later. This worked surprisingly well -- when I pulled the photos up later, the resolution of the screen was more than adequate to read what I had written, and the
multi-touch interface made zooming in on different sections of the note simple. I've began to photograph medical documents I might need to refer to later, like notes and lab tests.
A second option is the
DocuPen RC800
. (For a full description of this product, see the
Planon website.) This is a mobile color scanner for documents that's the size of a large pen. While it doesn't allow you to carry around a viewable image of the document itself, it does allow you to upload the scanned document to a computer for viewing later. Conceivably, the documents could also be uploaded to a service like
Box.net, an online storage system for documents and PDF files which, incidentally, has an
interface for the iPhone.
To summarize: Many records are still paper based. I'd love to see a system which allows easy digitizing of these records. And these records should be easily accessible by a handheld computer. And this computer, ideally, should have a user interface as elegant and friendly as the iPhone's.