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The Doctor Is In » EMR Blues

The Doctor Is In » EMR Blues: "This is a subject with which I have a more than a passing familiarity, having designed and developed an EMR software application for my practice over the past 12 years. Using an obscure but wonderful database application platform called 4th Dimension, I began in the early 1990’s to seek a solution for the repetitive mindlessness of dictating or hand-writing charts. Needless to say, a small project to create a database of chart notes and templates got wildly out of hand, and has now grown to well over 100,000 lines of code. Don’t try this at home, folks — at least if you want a life. I became so engrossed in this project that I even considered abandoning medicine and doing it full-time — a delusion which by God’s grace has since passed. But the logical-sequential perfectionistic obsessive-compulsive in me found a natural home in software development.


Now, apart from the huge black hole of time and effort in its development, my EMR is about as good as it gets. The software is designed specifically for the way I practice, right down to the dictation, data entry, templates and formatting style. I know exactly how it works; no training or familiarization necessary (my staff begs to differ, of course). I can — at least in theory — make it perform any task, exactly the way I want. And don’t get me wrong: it’s my baby, and I love it, and couldn’t get by without it. But it largely disproves many of the purported benefits of an EMR. So where’s the problem? What happened to Nirvana? Hmm, where to begin — here’s a few thorns in the flesh for starters:"

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