Back in October, we asked industry professionals and our readers to share some of the things they hated most about their EMRs. Since then, comments, questions and disagreements have sparked a lively conversation, prompting a look back to our original article.

From the classic paper-versus-electronic dispute to debates over HTML5, our comment section was brimming with thoughtful feedback. Throw in some follow-up emails to our original sources, and we have six reactions to the 10 things you hated about your EMR: 

1. Debates over HTML5. One original point, stating that EMRs tend to be outdated, led to some significant discussions. Natalie Hodge, MD, originally said software written in any kind of language that’s more than four years old is an issue. “If you’re using a system that’s written in Delphi, and a lot of old legacy systems are, then you’re missing out,” she said.  “Everything is moving to mobile, and systems should be headed toward HTML5.” Commenter Untangledjs, though, felt otherwise. “What enterprise-level programming language out there is less than four years old?” he questioned. “HTML5 is not a programming language, it’s for structure and presentation. There’s an actual programming language behind it doing all the heavy work to supply the calculations and data for HTML5 to make pretty.”

When we followed up with Hodge and asked for her reaction to Untangledjs’s comment, she wasn’t surprised by his response. “Your audience is widely healthcare-based, which is PC-oriented, so my views are perhaps as heresy,” she said. “[Untangledjs] is absolutely right: HTML5 is about structure and presentation, two of the key features missing in many of the software programs I’ve used in the past. Usability is defined by the users, not the guys in suits who are sitting in nice cushy offices contemplating how much of a bonus they will be giving themselves at year’s end.”

2. Paper vs. electronic. In our first bullet point, which stated some EMRs don’t measure up to paper, Shahid Shah, software analyst, expressed how frustrating it was when “developers and other IT professionals assume paper records and medical grade documents aren’t as important as structured data.” Deborah Peel, MD, added that EMRs were never built to comply with patient’s rights to privacy as opposed to paper medical records. Commenter danielgarcia, though, immediately dismissed their urgings that paper is somewhat better than electronic medical records. “Anyone who says that paper is better than electronic has no argument,” he wrote.

“You cannot start your argument by claiming that a paper process, which is slower and more cumbersome than an automated computer process, is better," he continued. "Without EMRs/EHRs, we have no argument … safety measures are there for patient information, more so than a paper one. You can present digital COT and NOPP forms to patients the same way you do with a paper and secure them better and retrieve them better. Advantages of a computer over paper, one storage, one managed approach, quick accumulation of data, and that means an improvement to the entire cycle of care.” Commenter SheaPF agreed. “Some of the statements are valid, but keep in mind with paper there is no progression or room for improvement,” he wrote. “It will never get better only worse but with EMRs, especially if they're Web-based.”

3. You don’t have to live with these issues. Commenter Awesterink said that, although he sees the point of our coverage, he believes there are solutions available that can alleviatethe issues we documented. “It is very important to go into the EHR selection process as educated as possible in order to select a system that will minimize these all too common issues,” he wrote. Kelly Mehler, our social media producer, responded. “I agree that in order for EMRs to be successful, everyone needs to be on board when it comes to the implementation and training,” she wrote. “Maybe that's where organizations can improve.” 

Continued on the next page.