IT pitfalls of doctoring

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Waikato District Health Board and four other regional health boards are implementing the Midland eSPACE programme.

The five-year project was designed to create a single point of access for clinical information across the wider region.

Waikato clinicians had expressed frustration with the current reliance on paper-based record-keeping, and the difficulties of accessing patient records from outside the district.

But in a commentary article published on Boston’s WBUR.org website – part of the National Public Radio network – three senior doctors had written about the pitfalls of electronic medical records (EMRs).

The trio said EMRs had become the bane of doctors and nurses’ lives and were the medical equivalent of texting while driving.

‘‘[M]ost EMRs create extra work. A lot of extra work, thanks to endless prompts with multiple choice answers that hardly ever fit the facts and that demand click after click to get anything done.

‘‘By the time the doctor can finally turn back to her patient, she will have spent close to half of the appointment serving not the needs of her patients, but of the electronic medical record.’’

The doctors argued computing was essential to the future of medicine, but EMRs needed to live up to the promise of improving care and making patient information easily available.

In reply, eSPACE programme head Maureen Chrystall said there was an awareness in New Zealand of the need to make IT programmes user-friendly and minimise the number of mouse clicks.

A strength of eSPACE was the fact it was a clinician-led project.

‘‘I just don’t think you can implement good systems without the involvement of key stakeholders,’’ Chrystall said.

‘‘If this is the system that clinicians practising medicine are going to use, then they’ve got to be involved in its development. It’s not a guarantee that we will get it right every time, but certainly they’re at the forefront of our thinking.’’

An estimated 6000 to 8000 clinicians were expected to use eSPACE. The development of eSPACE hadn’t been without its problems, including two false starts, changes in personnel and a $28m increase to its budget.

Waikato DHB consultant psychiatrist Dr Andrew Darby said because eSPACE was clinically driven, it would result in a lot of efficiencies.

The frustrations expressed by doctors in the Boston article mirror Waikato doctors’ views of the current record-keeping system.

‘‘They talk about the fact systems are different in different areas and that they [the systems] don’t talk to each other. I guess that’s one of the challenges that we have within the region, since we don’t have electronic systems that talk to each other, even though our patients flow across boundaries on a regular basis,’’ Darby said.

Concerns by US doctors that they spend a lot of time looking at computer screens instead of their patients could be addressed by simply repositioning their computer.

Darby, who chairs the clinical information reference group at Waikato DHB, was confident eSPACE would ‘‘traverse the chasm’’ which existed between healthcare workers across the various sectors.

It was also essential the patient’s voice wasn’t lost as health boards embrace the electronic age.