Why Lean Practitioners Hate Electronic Medical Records Software

About 6 weeks ago, my son broke his femur – yes, a very serious femur fracture. While playing soccer, the person guarding him kicked him behind his knee and the result was a broken femur. It turns out he had a bone cyst, which is a section of the bone that is weaker.

Apparently, most children outgrow their bone cysts or something like this happens. Thankfully, the surgery was a success and, 6 weeks later, he’s walking just fine. In about 9 months he’ll get his plate and 6 screws removed. Until then, he’ll be setting off metal detectors at the airport.

I’m so proud of my son: in adversity he responded with courage and a great attitude. It goes to show that a great attitude can really carry you through some difficult situations.

I bring this up we just returned from his 6 week check at the orthopedic surgeon. At the hospital where our appointment was at, they are in the middle of an Electronic Medical Records Implementation. The way the nurse described the effort to me was this:

“We’re turning a bazzillion paper based records into bits and bytes and finally I’ll be able to read doctors’ handwriting. Electronic Medical Records Software will help us a ton!”

This got me thinking about a few things:

• The benefits from having Electronic Medical Records
• The apparent tension between Lean and Technology

Electronic Medical Records Benefits

Just off the top of my head, I can think of a few benefits and advantages that come from having electronic medical records:

1. Less Paperwork: But not just paper, but less physical space that the file folders occupy. Also, I can envision search time is reduced as well as redundancies that come with not having to complete paper forms over and over again.
2. Reduced Medical Errors: Since, theoretically, information and medical history about a patient can be conjured in less time and with more accuracy, there will likely be less medical errors that come from poor or incomplete information.
3. Coordinated Medical Care: In situations where serialized workflow is important, such as (1) a visit to the primary care physician, (2) take lab tests, and (3) follow-up with primary care physician regarding the lab tests, then coordination between care is very important. In fact, I can’t think of an instance where coordination for medical care is not important.
4. For those with chronic medical conditions and co-morbid conditions such as diabetes with heart disease or diabetes with lupus or diabetes with obesity, or diabetes with diabetic retinopathy, it’s very important that the primary care physician, in the case of a diabetic, coordinates the care with the optometrist for diabetic retinopathy.

I’m sure there are more and these are just a few.

Tension Between Lean and Technology

In some circles, there is an apparent tension between technologist and the practitioners of lean manufacturing. On the one hand, the lean practitioner is looking at process and how to improve it; technology may or may not play a role as a solution to the problem. On the other hand, most technologist, generally, immediately default to technology as a solution with little regard for the underlying process.

I know this tension exist when it comes to ERP and MRP implementations. Lean practitioners would rather opt for a simple Kanban than some fancy automated and expensive monolith that often doesn’t work.

There is a growing field of Lean Electronic Medical Records, which aims to improve process first, then implement the Electronic Medical Records Software. This is an interesting and growing area.