The Incomplete Record

The standards have existed for years. Data stays locked in because locked-in data is what keeps hospitals from switching vendors and patients from switching hospitals.

Copy-forward, template bloat and defensive documentation have produced records that are technically complete and clinically useless. The next clinician skims it, because reading it properly is impossible.

After hundreds of billions in spending, the evidence that EHRs improve mortality, morbidity, or safety at scale is thin and contested. We adopted first and asked for proof later, and the proof never really arrived.

Two hours of screen time for every hour with patients is not a transitional cost, it's the steady state. Twenty years in, the efficiency gains keep being promised in the next release.

Most major systems were built to capture charges, and clinical workflow was bolted on afterwards. That single origin story explains almost every complaint clinicians have. Stop calling it a clinical failure when it's doing exactly what it was designed to do.