When designing EMRs, don't leave docs out of the loop

While the implementation of electronic medical records (EMRs) has been promoted in health policy circles as a key means of improving medical safety and quality, that's not always the case. Especially when physicians are left out of the loop.

Case in point: When Cedars-Sinai Medical Center in Los Angeles implemented new computer technology at a cost of $34 million, it resulted in a wide range of problems that ultimately caused the hospital to shelve it after 3 months. After that fiasco, hospital officials have no plans to try again at least for a year, according to The Washington Post (3/21/05).

Key among the problems was the lack of buy-in from the physicians with privileges at the hospital. The technology was created in-house with the input of just a few of the 2,000 physicians who would use the EMR system, and there was not enough training for the staff to feel comfortable using it. In addition, hospital administrators opted for "a 'big bang' implementation" instead of slowly introducing the technology one ward at a time.