When I was a kid my medical chart was paper. When I was around 13 years old the pediatrician’s office moved to an EMR.
It was more or less a digital version of the same chart.
As I have grown older, and with the benefit of having medical professionals in my family, I’ve seen how EMRs have changed from a distance. From an anecdotal perspective it seems like charting is more time consuming than it used to be. I’ve witnessed many different medical professionals using many different EMR platforms, and poor design seems to be a factor there.
They also deal with more information on a patient and in an aggregate form than paper charts ever did. From what I’ve observed I would venture a guess that more than a little of that is the result of neuroses and anal tendencies on the part of healthcare executives rather than quality improvement initiatives or research oriented objectives. There are other externalities like bad vendor implementation for CMMS requirements, or the continued granulation of conditions into ever more ICD codes, which then need crosswalk databases and interfaces and cross checks.
On the patient side, I’ve only ever truly been impressed by Epic’s portal. Every other one I’ve used is comparative garbage. I have recently been having a conversation with a manager at my doctor’s office trying to understand why and what changed so that chart data that used to be visible to me are now only visible to them, and why they can’t change that. It seems like the vendor implemented a forced change and I may just have to live with having ambiguously incomplete access to data I used to have access to, with no insight into what’s incomplete unless I already know.
With all of that said, at least there’s some access to one’s own health data. And comparing that to my birth records, which are functionally illegible (likely forever), at least what records are kept will be decipherable twenty years from now. Presuming they’re not mangled by a migration, which I’ve seen happen several times.