The map is not the territory: The missing patient in the electronic medical record

Faleh Alshameri, University of Maryland University College
Debra Hockenberry, Elizabethtown College
Robert B. Doll, Lehigh Valley Hospital and Health Network

Abstract

Purpose – This paper aims to, by looking at the electronic medical record (EMR) from three points of view, bring light to the dynamics that are essential and are currently missing in the USA. The traditional paper medical record has worked for physicians, management and patients since the beginning of practice. Yet the development of the EMR did not begin with all the essential elements of the traditional record that were working, but instead shreds out important aspects of the patient. Design/methodology/approach – Triangulation between three studies – medical, information technology and management studies. Findings – An efficient EMR has to take into consideration more than just one area of study. The dynamics between departments and users of the EMR need an integrated process that includes the necessary pieces of all involved. This hole has not been addressed in academic literature. Research limitations/implications – The paper triangulates three areas – medicine, management and information management. Most research on the EMR focuses only on one or two of these areas’ concerns. Looking at the three sides of the EMR is important to get a solid understanding of the dynamics that can occur relaying a patient’s story through various departments and uses. Practical implications – There is a depth, space and volume crucial to the comprehensive nature of medicine. With a perspective or dimension, necessary dialogues can be addressed and more intuitive tacit knowledge from medical expertise can be made available. A prototype, filling the holes of the observed elements in this paper, is possiblebyusing digital objects and including more information than the data of the day. Bringing accountability to the patient, more expertise to the fingertips of the physician and available data for management purposes area are the key ingredients for an effective EMR. Social implications – With a comprehensive EMR that works more effectively for those who input the data, the patient’s story can be documented with more detailed efficiency. Filling the holes of the observed elements in this paper all support better healthcare and long-term results for the health of society. Originality/value – The paper triangulates three areas – medicine, management and information management. Most research on the EMR focuses only on one or two of these areas’ concerns. Looking at the three sides of the EMR is important to get a solid understanding of the dynamics that can occur relaying a patient’s story through various departments and uses.