The clinician's perspective on electronic health records and how they can affect patient care

doi:10.1136/bmj.328.7449.1184

BMJ 2004;328:1184-1187 (15 May), doi:10.1136/bmj.328.7449.1184

Clinical review

The clinician's perspective on electronic health records and how they can affect patient care

Stephen H Walsh, consultant in acute medicine¹

¹ Birmingham Heartlands and Solihull NHS Trust, Solihull Hospital, Solihull B91 2JL stephen.walsh@heartsol.wmids.nhs.uk

The first 150 words of the full text of this article appear below.

Introduction

Many attempts to get clinicians to use electronic health recordshave failed, often because of difficulties with data entry.^1-4Technology should complement and improve clinical care, notimpose extra burdens on already overloaded medical staff. Theclinical "usability" of electronic records systems is particularlyrelevant with the recent appointment of service providers toimplement the national Integrated Care Record Service for theNHS as usability also affects patient care. I examine importantlessons learned from previous attempts to get clinicians touse computers in health care; discuss how clinicians actuallywork; make recommendations on designing or selecting clinicalcomputer systems; and explore how the use of electronic healthrecords might affect patient care.

How clinicians work

Patient documentation systems that try to reproduce previouslyaccepted models of clinical reasoning (pattern recognition,algorithms, or hypothetico-deductive models) have achieved limitedacceptance. According to Greenhalgh, the medical encounter consistsof stories within stories.⁵ Kay and Purves . . . [Full text of this article]

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Clinical perspective and potential benefits for patients: practicalities

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