IMHO:
Pros:
1) no calls for illegible handwriting deciphering
2) ease of looking up formulary, doses etc. as you're writing orders
3) order sets: click, click, click
4) reading other notes, image reports, etc.
5) if verbal orders are taken (ie, if you are at home with no access), easy to find orders in am to sign
6) orders may get taken off faster
7) less pharmacy errors
Cons:
1) nurses will refuse to take verbal orders, so you have to log in and put in order
2) rounds can take longer - it can take more time to open patient's chart, enter orders, click click click than to write order in chart
3) lengthy screens of orders may promote ignoring or oversight on some
4) to take orders off, nurses have to log in and look for alerts
5) on line notes tends to encourage lazy physicians to cut and paste daily notes from prior notes
6) templates click click click - again, can take longer if you have not designed the order sets to weed out orders you *don't* want
7) ease of JCAHO/administration types of putting new forms on the computer for you to fill out, adding to daily work
All in all, I find that I am slowed down by the EMR in the hospital with the exception of post-operative orders (for which I have personally designed order sets).
In the past, while seeing my patient in pre-op, I was writing the pre-op H&P update, the post-op note, post-op orders, write scripts, etc. and answering patient questions. Multi-tasking.
Now, I go in and see the patient, answer their questions and THEN go out of the room to find a terminal to fill in all the above forms, fill in the scripts, print them out, etc. The post-op/brief op note in particular is particularly time consuming...I have to type in the name of the anesthesiologist, for example, then scroll through the pop-up, find the name click on it to highlight, then ok to put it in the field, then close. Perhaps it saves time if the last name is Jagyecnuslogicalski but if its Ng, let me tell you...a much lengthier process.
Let's not forget the other forms that hospital admin has decided I also now have to fill out including a Tumor Staging Forum (its on the path report...can't someone just READ that?), Risk of DVT/PE, Discharge Summary (used just to be able to dictate - now have to dictate AND fill out form for Core Diagnoses, Discharge Status). "Hey let's just upload them to the EMR and make the docs do them now!" Yeah!!!
Ughh...I'm getting pissed just thinking about it.
So EMRs have perhaps made us more organized but they encourage needless extra work as well, IMHO.
