Most of the major medical records systems are iterations of 1980-1990s platforms that (particularly in the case of cerner, or which I have an ungodly quantity o

Most of the major medical records systems are iterations of 1980-1990s platforms that (particularly in the case of cerner, or which I have an ungodly quantity of experience with) were adapted from accounting software and are focused on billing (which is not really important where I practice but is a impact of the US medical system and incentives). The systems have horrific UI/UX with no consistency and every time a new feature was decided to be added a new button was added (ie imagine Word 97 with every toolbar enabled). As a clinician, you lose the ability to use nice shorthand (ie on morning rounds, the fastest way to convey your examination findings is to stick figure a person and draw lines/ticks/circles/x es through parts of the body to indicate your findings). You lose all of this with an emr. The long term contracts and aggressive vendor lock-in (cerner operates a proprietary database and doesn’t play nice with letting other people have access) means we are stuck with these systems possibly forever. If they were to be redesigned from the ground up it would be totally different but because they have microsoftjuggernaut style BD power the situation is really unlikely to be resolved in anyone’s natural lifespan. The impact on clinician well-being is immense. The impact on patient flow is immense - a deloitte study of Cerner Firstnet[0] in New South Wales emergency departments indicated a significant decrease in patient throughout - not surprising given the increased burden of administrative responsibilities imposed on clinicians, however something that has not ever been resolved - I work in NSW emergency departments and in places that still do not use first net I can cover 10-12 patients in a shift; in a first net hospital I am lucky to break 8 [0] https://www.google.com.au/amp/s/docplayer.net/amp/3816353-Doc-no-4-nsw-health-independent-review-of-lerner-firstnet.html https://www.google.com.au/amp/s/docplayer.net/amp/3816353-Do... Ultimately they are not fit for purpose, they are not designed for humans, they create patient safety risks (whilst now I think potentially decreasing some other risks due to automated systems monitoring observations etc) - medication management is horrific and makes it easy to make errors - and the situation is unlikely to change [0] https://www.google.com.au/amp/s/docplayer.net/amp/3816353-Doc-no-4-nsw-health-independent-review-of-lerner-firstnet.html https://www.google.com.au/amp/s/docplayer.net/amp/3816353-Do...