Miller Time

EMRs have a Reggie Miller problem.

Miller was a tall, skinny kid from LA who could really shoot the basketball.  Drafted by the Indiana Pacers in 1987, Miller ended his NBA career with over 25,000 points.  He could shoot from long range and had a penchant for making clutch shots at the end of important games.  As the kids say, ‘the boy could ball.’

But Miller had one big problem. 

He was born at the wrong time. 

Just before he joined the league, this other guy showed up.  Michael Jordan.  You might have heard of him. 

Jordan’s Chicago Bulls won six NBA championships in his 15-year career; Miller’s Pacers? None.  As good as they were, they could never get past Jordan and the Bulls.  Reggie is (unfairly) too often remembered as foil on stage while we oohed and aahed at MJ’s brilliance.

Poor Reggie.  Poor EMRs.

Like Reggie, EMRs were born at the wrong time, coming onto the scene at the same time as this other technology – the smart phone.

Few things summarize a physician’s expectations of, and frustrations with, their EMR better than the dreaded line that every EMR support person on the planet has heard too many times to count – ‘Why isn’t this dang (edited for public consumption) thing as easy to use as my iPhone?’  A rant generally follows.

I get it.  Docs, as proven by regular use of their omnipresent cell phone, are not the Luddite technophobes some believe them to be.  It is the EMR specifically they don’t like.

But there is a really critical difference between the gear Apple makes and the EMR you want to throw through a wall every day. 

As noted by Dr. Atul Gawande in his recent essay in The New Yorker magazine, the two systems have fundamentally different purposes:

‘Consumer technology is all about letting me be me. Technology for complex enterprises is about helping groups do what the members cannot easily do by themselves—work in coordination.’

 There, in two sentences, is a root of the physician’s frustration with their EMR, something that won’t be ‘solved’ even if we bring Steve Jobs back to life and outsource the whole thing to Apple.  My phone serves me and me alone.  I don’t care if even my wife finds it weird how I organize my apps on the home screen…it is MY phone.

The EMR simply has to serve many, many masters, not just the physician user.  Data sharing, connection to payers, communication with patients, billing, compliance, research – the list is endless. 

The implications of this reality are endless, resulting in a product that is beyond maddening for physicians to use.  That the correlation is high between physician burnout and the level of daily EMR-induced profanity (Can we get EIP established as a valid diagnosis?) is no surprise.

Can these be improved?  Of course…a lot.  That sermon is coming. 

But solved?  Nope.  Adjust your expectations accordingly.


20 − 14 =


Tim Coan, ALN’s CEO, writes an insightful and witty blog once a week about a variety of topics relevant to independent physician practices.

Yes, I'd like to get Tim's blog.