Why Every EMR is Bad

Daniel Paull, MD, an orthopedic surgeon in private practice, tells the world why he doesn't believe in electronic health records.

Electronic medical records are supposed to make things simpler for medical profession, but they do quite the opposite.


In its purest form, inputting information into a computer system so you can find and recall it is better.

It saves paper, it saves physical chart creation + destruction, and it certainly saves a lot of space in an office.

Notes are legible and easily transmissible.

This would be the situation if an EMR was just meant for notetaking, it would be better than paper charts.


Because electronic records are much easier to transmit, insurance companies decided that they want to read them to decide if you, the provider, deserve to get paid for the services you provided.

But, it’s not just someone combing through charts, it’s a machine auditing system that is primed to deny payments.

So it becomes an arms race with insurance companies requiring more things, and EMRs putting those things in there, even if they have no clinical relevance.


What we have today is EMRs that mainly prioritize billing.

What we are left with is barely intelligible, almost clinically useless notes.

These notes are a pain to write, and are bad. But they are good at convincing the insurance companies to pay.

The only way to ever get a “good” EMR is to stop billing insurances and start focus on actual notetaking.

They don’t need to be complicated in order to be good.


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