Why electronic medical records are this century’s greatest medical advancement Premium

Explore how electronic medical records revolutionize healthcare by enhancing patient safety, accessibility, and quality of care.

The year was 1997. A senior resident received an urgent call at 11 PM: drive across Miami to retrieve X-ray films for the next day’s surgery. His attending’s message was clear—don’t return without them. So, he climbed into his car and navigated the dark streets, hoping the other hospital’s radiology department hadn’t misplaced the films, that someone would be there to retrieve them, that he wouldn’t be the reason the attending would cancel tomorrow’s surgery. This chaos was routine medicine.

Before electronic medical records, hospitals operated like medieval libraries, running on hope and handwriting, with every piece of information existing in exactly one place at any given time. After morning rounds, residents would join queues in radiology, all waiting to view X-rays and CT scans. The films lived in the radiology department. If you wanted to see them, you went there. If the radiologist was using them, you waited.

The charts themselves were archaeological challenges. Physicians’ notes were often illegible scribbles—the infamous “doctor’s handwriting” wasn’t a joke but a genuine patient safety hazard. Critical information about an adverse outcome might be buried on page 47 of a 200-page chart. Previous hospitalisations at other facilities might as well have occurred on another planet.

I was in residency when I first encountered the United States Veteran Affairs electronic medical record (EMR) system. It was a good source of data—everything was documented and accessible—but painfully slow and inefficient.

By fellowship, things had improved. The EMR was still slow, but more efficient. You could sense the trajectory—this technology wasn’t just viable, it was inevitable.

Today, as I eat my dinner at home, my phone buzzes. A patient in the emergency department has chest pain. I open the app and within seconds I’m looking at their EKG. Anterior ST elevations—this is a heart attack, but the old EKG shows that this is not new. I pull up their chart: previous stent three years ago, allergic to ticagrelor, and creatinine slightly elevated. I review the troponin trend, check the echocardiogram, and I’m on the phone with the ER before my food gets cold.