Pagers, laptops, desktop computers, rolling mobile desktops, printed sheets, handwritten notes, flash cards…. It really boggles the mind how anything is kept straight in the massive constant flow of information and communication around a 770 bed hospital serving almost 30,000 inpatients per year between 550 physicians.

We had the opportunity to watch a residency program in action. From handoff and morning report to rounds, the EHR system was being used. The cutting edge of health records! However, it seemed more like an artifact from another generation of software. The interface was cluttered and required many clicks to get from one place to another. Perhaps this will evolve into a more streamlined layout.

What we would like to see: typeahead lookup, voice input, hotkeys, macros, de-cluttered interface, better use of data visualization, quick tagging/list building. Wouldn't it be cool if the doctors could "flag" and order the key records that they want to present?

The pressure is on for doctors to see as many patients as possible, communicate to various departments, and make sure all of this is logged in the EHR system. Many doctors are toting their own laptops, running from room to room, scribbling notes, and pausing to use fold down wall mount stands to catch up on their data entry. It almost seems as though doctors need their own personal scribe to take in data as they communicate with the patient (and of course actual and virtual scribe solutions are available - but what another possibility of miscommunication!).

The tough part of observing all of this is actually grabbing a busy doctor and asking them how they really feel about the EHR and why....Because they are too busy typing in the EHR!