EHRs

EHRs are trying to do the wrong thing. A clinical note, consultation or completed H&P express an elegant succinct communication between physicians and an ongoing novel of a patients progress. Not only does each encounter, each patient, each disease present a unique narrative, but each specialty and each physician contribute a unique perspective. No way can a team or an EHR reflect the color or content of a patient encounter. The physician dictated note alone can capture the subtleties of an encounter or facilitate continuity-of-care. The nightmare of entering EHRs in the presents of a patient pales by comparison to reading an EHR and trying to find what the previous physician was thinking among the vastness of irrelevant and superfluous misinformation, pages and pages of it.
       EHRs should be the preview of nurse alone and relegated to a separate file, Nurses Notes. Physician notes, dictated by the physician alone should constitute the official record. All the legislated requirements and their execution can remain in the nurse’s EHR.