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Doctor blogs about Epic - UnhappyCamper


Posted: Jun 08, 2012

Old Habits in the New Medical Order

Mark Crislip, MD, Infectious Diseases, 05:16PM Mar 15, 2012

 

I am getting too damn old and rather than the prior understanding with a knowing smile at the foibles of medicine, I find I am getting increasingly irritated.  It is a sure sign that I am getting to the end of my career.

 Maybe it is my increasingly discomfiture with the feeling that I never really know what is going on with patients.  People can respond to a perceived lack of control with many kinds of dysfunctional behavior including irratation.  Every other year I have to attend malpractice seminars as part of carrying malpractice insurance, and a lawyer mentioned in passing that the three big cases she was defending this year concerned misreading the EMR.

I believe it.  We are now all Epic, and in the torrent of tiny print and unneeded detail I have lost the ability to follow the narrative of the patients illness in the chart.  Given the ability of HCW s to personalize their progress note with volumes of imported garbage in any order they want, it is safe to say that after spending an hour reading the chart, I still feel uncertain that I understand the course of the patients disease.  The EMR is now for everything BUT communicating in a meaningful way about the patient.

I think there should be two notes for every patient: the computer generated note to document all the data you looked at to justify billing and a separate note that explained what is going on and why. The latter should take about a paragraph.  I spend a lot of time on computers, and there are real benefits to the EMR, but comprehending the patient s disease course is not on the list.

 

 

 

 

 

 

Interesting, thanks for posting. nm - MT55

[ In Reply To ..]
xx

I believe it. - RN2B

[ In Reply To ..]
I am studying to be a nurse, and I can tell you that EMR is not the end-all for medical data.

It took nearly an hour to thoroughly prep for the care of 1 patient, and data were not centralized in any one EMR screen. Labs were in one drop-down menu, meds in another, operative reports and HPIs somewhere else, code status in a different place...not to mention that some stuff was ONLY noted in the hard copy chart and nowhere in the EMR.

I'm betting most doctors don't have that kind of time to sift through the various screens on the EMR to collect all that data. I can appreciate this physician's frustration.

EMR - Epic user

[ In Reply To ..]
We use Epic where I work as an MT and are learning to adapt. As an MT I have no strong feelings one way or another, I'm just thankful to have a job. As a patient, however, I do not like Epic. The nurse or PA who checks you in sits with her back to you with her head in the computer. The doctor spends about have his time accessing info and entering data, I don't feel that I get the attention that I used to get. I transferred my care to a different doctor who has the courtesy to wait until after my visit to start entering data. I think Epic is more centralized than what you describe. Patients also have the ability to access their basic info via a website, which some people may like. I miss the days of one on one doctor-nurse-patient interaction, though.

it's true! Plus, - OpticalPoptitude

[ In Reply To ..]
...my doc has this incredibly loud keyboard, & he clacks away on it for the entire visit. It is so distracting I can hardly answer questions, and I've had to ask him to stop so I can think.

Sheez.


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