In general, I think that EMRs try to cram as much information onto the screen as possible, without enough thought toward what pieces of information are useful at particular times. It's like the opposite of the experience that I have on a well-designed website. Most of my complaints are around that phenomenon, as well as all of the unnecessary clicking / scrolling required due to poor design. I also think that the cost of implementing / migrating these systems is insane, especially when that just adds to our already overpriced health care system. It's hard not to think that companies that build EMRs prefer to be as closed and proprietary as possible, to prevent an easy switch to a competitor.
A few things that I do like in Epic and think are generally good features in EMRs: -lots of shortcut keys -saved phrases (I think they're called "smart phrases" or some nonsense like that) -single click connectivity into clinical resource websites and some hospital portals -modern browser support (I seriously used to use an EMR that could only be accessed on an old version of Internet Explorer -- "just make sure you don't let the computer update the browser") -eprescribing
My favorite EMR of the 10 or so that I've used was at the VA. (I've heard, though not verified, that that EMR was licensable for almost no cost outside of the VA, but was ignored in favor of "nicer" systems.) I don't know if it is the same now, but it was extremely simple in appearance with some basic fields for writing notes, an image viewer, a quick way to order and review labs, etc. Looked almost like a terminal. Copy/paste functionality. Most importantly, because it was used at every VA in the country, I was able to easily review records/labs/images from, for example, a 65 yr old veteran who had just moved from across the country. No faxes, no scanning. It is this sort of uniform system for data access that we are missing right now in medicine in the US and it is wasting time, costing us a lot of money, and damaging patient care.
