ZURICH - “If you add one more useless initiative and one more piece of paperwork, I’ll jump out the window.”¹This is what you may hear when you approach a doctor or a nurse when confronting them with a new software that you want them to use. But, why that visceral reaction? Isn’t the move beyond paper, pen, and fax machines in healthcare a good thing? Don’t we finally have all the technology we need - soft- and hardware - available at our fingertips to ease the lives of doctors, nurses, and other healthcare professionals? How come that the first generation of electronic medical records (EMR, or often referred to as EHR, electronic health record -see below figure) has been such a failure in the eyes of many?²

To understand the context, let’s look at the value chain from the patient’s perspective: patients receiving care, providers delivering care and payers paying for that care. Remember the last time you went to see a doctor? There’s a high chance that while you were telling them your story, answering their questions, and putting forward your concerns, they would seemingly not pay attention but be hidden behind a computer screen. Why? Because of a system that is paranoid about numbers and documentation. Maybe that’s for justified legal reasons; maybe it’s for necessary billing reasons; or maybe it is for delivering better care through carefully tracking a patient’s story over time? The answer is likely to be all of the above. But shouldn’t it really be only about the latter? Today’s reality of a so-called fee-for-service system leads to an unprecedented pressure to produce. The system incentives numbers and quantity of services, products and procedures rather than rewarding the quality of care. It makes a doctor’s life resemble more the job of an accountant than a life at the forefront of patients’ needs.

So far so good. Other than an unpleasant feeling at the doctor’s office, what precisely is the issue?