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Regarding Epic system. How will the EMRs do regarding OR reports. Will that go to Epic or will the - PAMT

Posted: Dec 20, 2011

speech or straight transcription. Just wondering about that and DS, Consults, etc.

My brief experience - Happy MT Robin

[ In Reply To ..]
I worked for ExecuScribe last year and their biggest account went to EPIC. The op notes were not scheduled to be one of the first to go, but apparently the hospital found it so easy, they moved those onto the system much faster than anyone expected.

I don't have a huge experience with op notes, but the ones that I have done have an awful lot of canned text from the docs, so I expect that they would do pretty well with EPIC, unfortunately for us.

I don't know how consults and discharge summaries can be done on EPIC. Some of it, like the past medical history, allergies, etc., yeah, I can totally see that, but not the HPI or Assessment narrative. I would get these 50 minute long consults from the residents. I just don't see how that translates to a drop down menu. It did, though, because my department (Oncology) was one of the first ones to go on the system.

I did have a comment from someone at another job, though, who said they had lost some accounts to EPIC and a couple of years later they came back to the same company and were going back to a dictated narrative.

OP notes did not go to Epic in my hospital sm - MT2

[ In Reply To ..]
neither did cardiology. Everything else did. Epic pulls in much of the data from the electronic record and doctors use point and click for the rest. What is dictated is only partial dictations, oftentimes just a sentence or two. Greatly eliminates the need for many MTs.

Epic - MT

[ In Reply To ..]
Transcription dropped to almost nil. They dictate maybe a paragraph, everything imports, including mistakes. A real mess.

EPIC procedures. - ourfuture

[ In Reply To ..]
Procedures that record what is being done via imaging or camera are plugged into a template. Caths and "oscopies" disappear from transcription. No need. EPIC provides a summary complete with imaging pics to demonstrate what was seen. Any procedure that is can be reduced to a template becomes a template. If dictation is done at all, it is just to relate history and sometimes impression and plan. All else is pulled from the database. It is genuinely ingenious and cutting dictation by around 50% to 60%. It won't completely replace us as yet, but it is well on its way.

Surgeries that cannot be reduced to a template are still dictated.

Thanks, guys, for experienced observations. From - someone with experience in liability

[ In Reply To ..]
insurance, torts, lawsuits, etc., I'm certain these uncorrected mistakes going into medical records now are live bombs ready to go off. Facilities have to know this, but saving money is presumably a more pressing priority, with the other a problem for a future that will come.

Thus, I am also quite certain that, one way or another, the review-and-correct process will have to be restored to medical records. Whether by physicians spending an hour a day at it, or someone else.

Before then, though, probably many more providers will switch to a process that attempts to minimize this problem by eliminating narrative. That will also severely negatively impact patient care, with resultant correction back to at least some narrative. At least for acute care.

If I were younger, or even lived in the city, though, I would not dream of trying to wait all this out. It's going to be a bumpy ride...

My NP told me this.. - DZ

[ In Reply To ..]
She said she was having a hard time with Epic and she asked one of her coworkers why he thought it was so great. He said he thought it was initially, but now not so and he does what is required of him in Epic and he dictates as much as he can. I think the young physicians up and coming who are brought up on technical stuff will have no problem with it; the older a physician is (and if not tech savvy) the harder it will be. My company (not MTSO owned) is transitioning to Epic. So far we don't see a lot of decrease in volume, some, but not a lot. The doctors can't even put in the correct facility code (makes us responsible for that) so how in the world will they make sure they are putting in the correct stuff by a click of a button, cutting and pasting. While the bottom line is saving $$, I wonder if this will come back to bite some in the behind at first. Unless a company makes it mandatory that a physician dictate a certain percentage of his/her dictation in Epic (or rather do it in Epic) I wonder how much will really be done. It's great in one aspect: A person can be seen at multiple facilities (clinics, hospitals) that are all one company and that physician will have access to all of the patient's records. Time will tell.

The TRUTH About Epic - Seeker

[ In Reply To ..]
From a cardiology resident's perspective.

This is rreaking hilarious! But scary at the same time.

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