If you got together the best user experience professionals in Silicon Valley and invested billions into the creation of The Best EHR in the World, doctors would still hate it.

They would complain that The Best EHR in the World is destroying medicine and hurting patients. Long essays in the Sunday New York Times would wax nostalgic about the good old days before the The Best EHR in the World. This, of course, would provide perfect PowerPoint pull quotes for bowtie-wearing medical lecturers bemoaning our dystopian clinical state.

“With one hand carefully clutching the manila bound medical record and the other hand gently fixed on her arm, he stared empathically into her eyes…”

The Best EHR in the World wont fix our rage against the machine because it’s less about design and more about what’s required of doctors. Sure design has a long way to go. But the problem doctors have, especially Industrial Age doctors accustomed to writing on paper, is the process of creating documentation consistent with what’s required by law.

We can blame the technology but it’s probably the process.

I know because I was there. When I first went into practice my documentation was chicken scratch for no one else but me. “The plan of care? It’s between my ears,” I would wink and say to my nurse while flying into the next room.

It’s challenging to create accountable documentation when you’re moving fast. And The Best EHR in the World will never make better what we are now called on to do.

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Image modified on Flickr via BenBen