[Legitimate resistance without technophobia: Analysis of electronic medical records impacts on the medical profession]

Abstract

The objective of this short narrative literature review is to highlight the different difficulties encountered by medical doctor in the daily use of EMR. We show that these are not simple transitional phenomena related to a "resistance to change", but rather the fact of a deeper and unfinished transformation. Beyond the "perception of misfit with work processes" or the threat of a loss of autonomy, we propose to analyze this so-called "resistance" in relation to the formalization of medical work induced by EMR. Our question concerns the compatibility of the multiple objectives of EMR, the potential influence of computerization on the steps of entering and consulting medical information, the impact on the clinical reasoning, the reality of assistance to medical "performance". The question is not so much what EMRs do less well than the paper record, but to provide insights into how tomorrow's EMRs will do better than today's.

Keywords: Clinical reasoning; Digital hospital; Dossier patient informatisé; Electronic medical record; Health information system; Hôpital numérique; Médecine narrative; Narrative medicine; Raisonnement médical; Système d'information clinique.