The same CBC article (on Canadian doctors’ love-hate relationship with EMRs) that featured Dr. Greiver’s EMR also published this comment that didn’t sit very well with me:

"Let’s be honest," says researcher Dave Ludwick. "Doctors have gone to school to become doctors, to understand how the body works and remedy that body’s failings, not to do IT. And yet with electronic records, IT suddenly becomes their job, too."

I am aware that this doesn’t exactly say that IT isn’t the physician’s job, but it’s certainly implied.

So what gives? Why the downer attitude?

If all jobs matched their job descriptions, the world would be a very foreign place.

Then I thought about the “description”…

In Canada, we have a famous diagram of the CANMEDS competencies (“a guide to the essential abilities physicians need for optimal patient outcomes”):

Indeed, our medical schools are crazy about this flower. Pre-medical and medical students do their utmost to present themselves as embodying these traits. You don’t get a more widely-accepted job description here than this…

And I think that every single petal is relevant to the EMR debate.

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The film “Up in the Air” is — ostensibly — all about George Clooney. Ryan Bingham (George Clooney) travels across the country 300+ days of the year and fires people for a living… Because bosses get scared and emotional ex-employees tend toward regrettable actions.

But “Natalie Keener” (Anna Kendrick) truly steals the show.

Natalie is the young hotshot character. She’s convinced Ryan’s boss to replace the guys’ jet-setting ways with New Technology: firing people over the computer screen. She’s going to make Ryan irrelevant, and the firees along with him.

Now replace “firing people” with “seeing patients”. Does the funny feeling grow?

This is the major reason “telemedicine” sets off alarm bells left and right.

We can accept pushing the “tele-” prefix onto other words. But not “medicine”. Medicine is sacred. Why? Because it should never be impersonal.

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Update (Jan. 15th, 2010): Thanks to Dr. Vartabedian (@Doctor_V) for featuring this campaign on his blog 33charts!

Here it is: I snapped a photo of the Privacy-In-Practice posters that University Health Network (UHN) has posted in its hospitals.

Looks like “Facebook, Twitter or blogs” are the big shots here. Do you think there are any other popular social media avenues that deserve to be listed as well?

For more information, see the post I wrote about seeing these posters for the first time last semester.

*I promised I’d share Toronto physician blogs if I found them, so here’s a GREAT one: Dr. Greiver’s EMR. She’s a family doc in North York and was recently featured on the CBC for her > 4 year documentation of the peaks and valleys of running with the Nightingale EMR (one of the ones subsidized by the Ontario government).

Today’s post is inspired by Dr. Greiver and a lifetime of paper-love.

There’s just something about paper. You can’t get rid of it.

A few examples:

• I start reading many books on the computer and subsequently quit for a hard copy from the library.
• Lifehacker polled its readers for the Five Best To Do List Managers, ostensibly looking for applications, and guess what came out on top? “Pen and paper.”
• Stats Canada: “paper consumption has doubled over 20 years even as Canadians adopt new technologies”.

I think it’s safe to say that the paperless office/home is a myth.

Now, as EMR, EHR, PHR proliferate, there’s even more evidence that paper just persists…

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The success of electronic medical records (EMR) depends on much more than the EMR itself, but intuitive, smart software is still important. In this post (Merry Christmas!), I will talk about one tough issue in particular, the search problem, and why a “finder” like Google Wave (June, November) might be a good idea.

Larger electronic record projects may show us what’s needed.

Yesterday, I read an article (National Post) on MyLifeBits, a kind of Electronic “Life” Record. Since 1998, Gordon Bell, a principal investigator at Microsoft, has led a project to “go paperless”, essentially scanning, recording, logging every single thing in his life.

The motivation?:

I’m not cluttered with having to remember any of this stuff. I just have to remember that it’s in there, and that I’ve looked at it.

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