Lexington Books Unintended Consequences of Electronic Medical Records: An Emergency Room Ethnography

Unintended Consequences of Electronic Medical Records: An Emergency Room Ethnography argues that while electronic medical records (EMRs) were supposed to improve health care delivery, EMRs' unintended consequences have affected emergency medicine providers and patients in alarming ways. Higher healthcare costs, decreased physician productivity, increased provider burnout, lower levels of patient satisfaction, and more medical mistakes are just a few of the consequences Barbara Cook Overton observes while studying one emergency room's EMR adoption. With data collected over six years, Overton demonstrates how EMRs harm health care organizations and thrust providers into the midst of incompatible rule systems without appropriate strategies for coping with these challenges, thus robbing them of agency. Using structuration theory and its derivatives to frame her analysis, Overton explores the ways providers communicatively and performatively receive and manage EMRs in emergency rooms. Scholars of communication and medicine will find this book particularly useful. Review Barbara Cook Overton's book documents the profound and pervasive changes brought by the transition from paper charts to EHRs. It can be relevant to a broad audience, including not only scholars of health systems, but also policymakers, hospital managers, providers of care, and health IT designers. The final chapter of the book provides useful practical suggestions on how to make the EHR system better serve the interests of the healthcare community.--Sociology of Health & Illness Barbara Cook Overton richly illustrates the devastating consequences of the massive structural changes institutionalized by the adoption of electronic medical records systems in emergency medicine. This well-documented ethnography is soundly rooted in a number of rich theoretical traditions, applying and extending them in a multifaceted investigation that is conceptually and methodologically rigorous. This book should worry us all and should be required reading for all healthcare system executives and health IT professionals.--Anne M. Nicotera, George Mason University Barbara Cook Overton's new examination of communication in U.S. Emergency Departments, Unintended Consequences of Electronic Medical Records: An Emergency Room Ethnography is a superb description and analysis of the real world difficulties the requirement for EMRs created for Emergency Department (ED) teams. This new book uses participant observation, thick description, as well as interviews of ED providers, to illustrate the problems adoption of EMRs have presented to staffs, patients, and hospitals.--Michael P. Pagano, Fairfield University Unintended Consequences of Electronic Medical Records: An Emergency Room Ethnography by Barbara Cook Overton details just how difficult it has been to computerize the actual process of delivering front line care in one critical area of the hospital -- the ER. She presents in detail a litany of significant problems that have resulted from the installing of EMRs and how they can negatively impact a patient's visit to the ER. The book is a powerful read detailing how all may not be well in your local emergency department -- and how computerized medical records is a major cause of it.--Richard Bukata, MD About the Author Barbara Cook Overton holds a PhD in communication studies from Louisiana State University.