Unintended Consequences of Electronic Medical Records : An Emergency Room Ethnography

This book argues that the unintended consequences of electronic medical records (EMRs) do more harm than good—namely, that EMRs negatively impact health care providers, threaten patients’ safety, and bankrupt hospitals. The author examines ways in which EMRs fundamentally change emergency medicine practice and providers—not always for the better.

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 health care costs, decreased physician productivity, increased provider burnout, lower levels of patient satisfaction, and more medical mistakes are just a few of the unintended consequences Barbara Cook Overton observes while studying one emergency room’s EMR adoption. With data collected over six years, Cook 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, Cook Overton explores ways providers communicatively and performatively receive and manage EMRs in emergency rooms. Scholars of communication and medicine will find this book particularly useful.