Why doctors hate their computers (2018)

Summary

“You can’t learn more from the system,” she said. “You can’t do more. You can’t take on extra responsibilities.” Even fixing minor matters is often not in her power. She’d recently noticed, for instance, that the system had the wrong mailing address for a referring doctor. But, she told me, “all I can do is go after the help desk thirteen times.”Jacobs felt sad and sometimes bitter about this pattern of change: “It’s disempowering. It’s sort of like they want any cookie-cutter person to be able to walk in the door, plop down in a seat, and just do the job exactly as it is laid out.”Sadoughi felt much the same: “The first year Epic came in, I was so close to saying, ‘That’s it. I’m done with primary care, I’m going to be an urgent-care doctor. I’m not going to open another In Basket.’ It took all this effort reëvaluating my purpose to stick with it.”Gregg Meyer sympathizes, but he isn’t sorry. As the chief clinical officer at Partners HealthCare, Meyer supervised the software upgrade. An internist in his fifties, he has the commanding air, upright posture, and crewcut one might expect from a man who spent half his career as a military officer.“I’m the veteran of four large-scale electronic-health-records implementations,” he told me in his office, overlooking downtown Boston. Those included two software overhauls in the military and one at Dartmouth-Hitchcock Medical Center, where he’d become the chief clinical officer. He still sees patients, and he experiences the same frustrations I was hearing about. Sometimes more: he admits he’s not as tech-savvy as his younger colleagues.“But we think of this as a system for us and it’s not,” he said. “It is for the patients.” While some sixty thousand staff members use the system, almost ten times as many patients log into it to look up their lab results, remind themselves of the medications they are supposed to take, read the office notes that their doctor wrote in order to better understand what they’ve been told. Today, pa...