Dr. J.’s biggest complaint regarding the electronic medical record is that it can ‘cut and paste.’ This time saving feature has the potential to cause and propagate errors if you are the sole provider (e.g. private practice physician) using that specific record. Now if you work somewhere like the a large academic medical center or a Veteran’s hospital where a patient’s record is necessarily being accessed by all providers across the continuum (i.e. the primary care provider, surgeons, specialists, nurse practitioners, residents, medical students, nurses, nursing aides, etc….), erroneous data can in there forever. A couple of months ago, there was a line item in a patient’s past surgical history, “Coronary Artery Bypass Grafting – 1996” but the patient had no scar on his chest. We don’t know how the error got in there, and Dr. J. was able to write a comment in his note and updated the problem list, but there are 15 years of notes where CABG is mentioned.

XKCD.com has a funny cartoon about error propagation in the electronic era…

Dr. J.