Are "templates" helping or hurting you?

A lot of EMR vendors use templates in order to speed up the more common exams.  So, instead of seeing a blank exam form every patient encounter, you at least are presented with some form of "normal" data.  For instance - if a 20 year old established CL wearer comes into your office, you may want to open the template thay says "this patient has already worn CLs and is aware of all risks" instead of the template thay says "Patient is interested in CLs and is unaware of any risks or benefits."  Seems like a good idea, but are they really helping us out or causing more problems overall?  Is there any benefit?  Why do we even need templates?

Let me explain...

I use an EMR that is built upon templates.  It comes pre-loaded with about 10 templates for Adult Routine, Youth Routine, Established CLXM, New CLXM, etc.  In some cases which are completely straight forward, these templates do indeed save time - but I think I'm losing the same amount of time "repairing" these templates for those patients that do not fit the mold of my templates.

Example 1:

A new CL wearer arrives in your office.  He has worn CLs that were prescribed sometime in the past by an OD that he does not remember.  So, you open the "Establish CLXM" template.  My "Est. CLXM" template basically says that the wearer has perfect comfort, vision, etc and that everything is perfectly fine.  But this patient happens to not have seen an OD for 3 years, has extensive NEO, edema, GPC and a infiltrates over OS.  Now, the exam turns into an eye problem and I'll be there for about 5 minutes repairing the exam and basically "re-doing" all of the items that are now incorrect.  That 5 minutes probably removes 2-3 minutes worth of time that I "saved" using a template on another patient.

Example 2:

An 84 year old female comes in for a "routine" eye exam.  You open the "Comprehensive Adult" template.  She's got diabetes, pseudophakia, amblyopia, past Hx of glaucoma suspect.  No template in the world will be good enough for this patient.  In this case you'd probably want to just start an exam from scratch with no template... except that you're using an EMR that is built upon templates and it takes you just as long to start from scratch as it does to repair a template - maybe longer.

My theory is that it would be better to revert back to paper exam "types", but in an EMR form.  Remember paper exams?  We only had about 3-4 different exam forms in my office...

1. Routine Exam for glasses
2. CL XM sheet
3. Eye Problem (office visit)
4. IOP Check/ glaucoma exam form

I think that companies use templates as a crutch as their programs are difficult navigate.  They look or feel nothing like a real paper exam.  This is not entirely their fault; however, it is extremely difficult to design an interface that has been multitude of options that a paper exam form is capable of.  A piece of paper can be anything... It can be a dental record, a medical record, or even a drawing.  It will only be when we have newer, more intuitive interfaces that we can finally drop templates and began to go back to our roots -- a paper-like form.  It is the computer form itself that is requiring templates.

So, what do you think?  Do you think you like templates?  Do they speed you up or slow you down?  A little of both I bet...