Revamping EHRs: Striving for Authenticity in Patient Documentation
MedPage Today
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Contributed by: Kate Gamble
Summary
The transition from paper charts to electronic health records (EHR) has streamlined documentation for medical professionals but has also led to a focus on billing and compliance at the expense of capturing meaningful clinical details. Fred Pelzman, an associate professor at Weill Cornell, emphasizes the need for EHRs to provide an authentic representation of patient interactions, as highlighted by a New York Times investigation showing discrepancies in the documentation of methadone clinic counseling sessions. He critiques the excessive detail in progress notes that obscures true patient-provider interactions and advocates for more accurate, relevant documentation reflecting actual consultations.
