Alan Weiss, MD, MBA is director of medical informatics with Memorial Hermann Medical Group of Houston, TX.

Tell me about yourself and the organization.

I’m a general internist by training. I have a computer science background and an MBA. I’ve been involved in the development of EMRs for about 15 years. I practiced at the Cleveland Clinic for about 10 years doing EMR implementation and practicing.

I’ve been at Memorial Hermann for about a year and a half. It’s a 10-hospital system, about to become a 12-hospital system, with an outpatient medical group directly affiliated with about 170 providers. We’re a GE shop on the ambulatory side and a Cerner shop on the inpatient side. We also have an affiliated group of physicians, about 600 to 700, on a whole different group of EMRs, with our biggest one probably being eClinicalWorks. We are the largest healthcare provider here in Houston.

What is the state of EHRs and in what areas should they be better?

EHRs need to improve. When people talk about the current state, I always think about what the basics are of EMR — what does it have to do? It has to be able to allow providers to look at data, to enter orders, and to write notes in a clean and efficient manner. A lot of the EMRs don’t allow for this. Each EMR has its benefits and its drawbacks, but if you can do those three simply and easily, that’s when providers can use the tool as best as possible.

What is the place for the doctor’s true narrative and rather than text generated from click boxes?

I think we’re going to see a throwback away from the computer-generated text and back into true narrative. It’s gone too far. It doesn’t have a whole lot of meaning and notes are way too long. It doesn’t convey the clinical impression, which is what we need to provide the best care we can.

It wasn’t doctors who originally wanted to click boxes to create text. Do they have enough voice to turn the EHR back into a record that’s for them and not for someone else?

There are providers out there who love the being able to do all the clicking of text and checking the boxes to get things done. But it’s more to get things done, not to create the narrative. The problem is that the narrative that’s created through clicking boxes becomes a hard to read mess.

I think we’re going to see everything change back into a much better narrative. A better way of actually describing what providers want from the EHR, which is an easy way to document, but also a way that gives their notes meaning to them.

What parts of the note could give clinicians an …read more