4. It’s cumbersome. Based on Shah’s experience, it often takes longer to document a note in an EMR that it does to do the same thing in an email editor. “And it certainly [takes longer] than it does on paper,” he said. Twitter user and medical doctor Jacqueline Sequoia (@jsequoia) agrees. “[The] problem lists in the #EMR are being misused,” she tweeted. Sequoia went on say the lists generated by an EMR only create more work for her and her colleagues. Hodge said instead of some systems saving time, they create more steps than necessary to complete a task. “In some old systems, you need eight clicks to do one thing,” she said. “I’ve used charts that were horrible. I would say this to developers, and they would show me how to do what I needed to do but eight clicks later.” Hodge said to fix this problem it’s essential to find companies that understand users are the ones “driving the boat.” “They need to have a willingness to listen so applications can become more user-friendly.” 

[See also: EMR links Montana centers.]

5. It’s ineffective. “It’s nothing more than an electronic typewriter and doesn’t add much by way of clinical improvements,” said Shah. “It doesn’t help me improve my practice, market my services, or monitor my patients’ health in a way as to make it useful on a daily basis.” Peel agrees and took the standpoint of a patient. “When I see my psychotherapist, for example, I am supposed to be asked for consent before my ‘psychotherapy notes’ are disclosed, but most EHRs don’t have a way to keep those notes separate,” she said. “This denies me the right to prevent people from seeing them who have need for that information, like a surgeon or allergy doctor.” Twitter user and medical doctor @JackWestMD noted one challenge with his hospital’s EMR is it ironically produces more paper instead of eliminating it. “One problem with electronic med records (#EMR) is that it's very easy to generate 100s of pages of paper.” He continued by saying most of the time, this information isn’t useful.

6. It doesn’t allow for patient interaction. Hodge said unlike systems that run on laptops or desktops, EHR apps that run on iPhones and iPads allow for a greater amount of patient interaction. “Laptops can take away from the patient, while the iPad adds to patient interaction,” she said. “You can tweak it and show it to the patient; you can show them pictures, videos, and more. It’s not just the experience of charting. It’s getting your experience of charting mixed with patient education.” Shah agrees and added, “I can’t share the notes that I want with patients. My EHR doesn’t encourage or allow collaboration with them.”

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