Ironically, the same electronic health records (EHRs) initially designed as a tool to help physicians diagnose diseases have largely evaded diagnostic scrutiny. Talk to physicians who utilize them on a daily basis, however, and it becomes abundantly clear that today’s EHRs are ailing. They are adding hours to the physicians’ workday, siphoning attention from patient care, and sowing the seeds of demoralization across the profession of medicine. To address this problem effectively, physicians need to shift their focus from the symptoms associated with EHRs to the underlying diagnosis.
A key to arriving at the most accurate diagnosis is to cease treating EHRs as information technology problems and instead regard them as organic problems, not so different from the categories we would use in diagnosing a patient. Specifically, we need to seek out a known disease or diseases onto which many of the problems with EHRs can be mapped. In so doing, it is not our intention to stigmatize any disease or the patients who suffer from it, but instead to help physicians peer more deeply into the nature of the electronic malady with which they are wrestling.
We have concluded that contemporary EHRs meet the diagnostic criteria for autism. Introduced in its modern sense in the early 20th century, the term autism is derived from the Greek word autos, meaning self. Fittingly, autism was originally understood as a morbid degree of self-obsession. Today, we associate autism with impaired interaction, poor communication, and restricted patterns of behavior. Each of these features of autism can be found in contemporary EHRs, and for this reason, we propose that such systems — and to some degree, the individuals responsible for their design and implementation — be treated as autistic.
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