Viewpoint: 4 ways the EMR is an ethical disaster

EMRs are an expensive clerical burden that haven't fulfilled their promise to use  meaningful data to inform better patient care, and EMR vendors have profited at the expense of the physician-patient relationship, Jamie Wells, MD, writes in an op-ed for the American Council on Science and Health.

"At their best, they added another layer between physician and patient further eroding the relationship and at their worst, they were borderline negligent contributing to a premature exodus of seasoned professionals who had more to give patients and those who came after them professionally," Dr. Wells writes. "Which brings me to my main concern of whether or not such forced implementation of EMRs, considered by some as coercive, violated the basic tenets of bioethics."

Here are four ways Dr. Wells argues the EMR creates an ethical disaster.

1. Respect for autonomy. Neither  physicians nor  patients were asked about the use of EMRs — the mandate was simply instituted. Meaning patients were never informed about the risks and benefits associated with using EMR data to inform care plans, nor were they warned the tech could take away from the face- to-face time with their physicians.

2. Justice. Dr. Wells argues penalizing physicians — many of whom did not grow up with technology and know how to use it — is unfair as it led to early retirements. Additionally, the EMR, which prompts physicians to ask questions that may not relate to the patient, forces the patient to have less control over their care. "In addition, preoccupying their doctor with unnecessary extra steps can slow down a patient’s getting relief from their suffering. This is not fair to individuals seeking or providing care," Dr. Wells writes.

3. Beneficence. EMRs create unnecessary challenges that affect physicians' abilities to provide the highest quality of care. "Transforming their physician into a data entry specialist by consuming their time erodes the doctor-patient relationship, chips away at things like bedside manner and effective communication that all can impede care," Dr. Wells writes, adding that EMRs keep physicians in the office longer and "excessive training and continued education are involuntarily required by staff to remain certified on their respective system."

4. Non-maleficence. Because EMR systems are not interoperable, patients deal with delays and inconveniences that can infringe on a patient's choice of caregiver. "EMRs routinely exacerbate the difficulty of getting the information," Dr. Wells writes.

Click here to read the complete article.

More articles on EHRs:
Top 5 reasons patients decline access to EHRs, according to ONC's study
National Academy of Medicine releases ONC-funded report on improving clinical decision support
Black Book: Duplicate patient records cost hospitals almost $2k per inpatient stay

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