The following is posted on behalf of Dr. Gerald Tevaarwerk:
"Having used computers in my office since the late 1970s as well as in hospitals and having followed the literature on electronic medical record keeping (EMRK) quite closely I am surprised at the paucity of head-to-head comparisons of electronic and paper record keeping. Being an evangelist for office automation one runs the danger of being carried away by personal enthusiasm.
Recently having returned from the Netherlands and looked into their extensive use of EMRK it was again impressed upon me that using it takes more time per patient. Part of the reason is the decrease in eye contact for which time compensation has to be made. Another reason is the greater completeness of the record which in turn causes patients to ask more questions and they like to view graphs and tables, adding to the discussion time.
Interestingly, even for hospital systems there is relatively little evidence-based research in the literature of the cost-benefit of using EMRK. Cost, including loss of time, real or imagined, is a significant barrier to implementation by individual physicians. The major beneficiaries of EMRK are the patient and the payer but we as physicians must make a business case for its introduction in our offices. I wonder if any contributors to CanadianEMR might help me find head-to-head comparisons of EMRK in physicians offices, especially cost and time comparisons. Most useful of course would be randomized trials.
Thank you for your efforts in helping to assess a development that holds great potential.
Gerald JM Tevaarwerk, BA, MD, FRCPC, CertEndo."
If any contributors or readers of CanadianEMR are aware of studies that provide head to head analysis of EMR systems, please add your comments by clicking on the 'Comments' link below.