Any Doctors On The Forum?

[rohit1974]

Hi there. Am a doctor and working in medical oncology. Though we have eHIS but stat notes, MAR sheets need to be written by hand so there is always an opportunity to use fountain pens.

[Arkanabar]

You will hate electronic records. These programs are designed to aid government and insurance companies in mining patient data, not to make medical care better or more efficient. In fact, they will slow you way down as you try to squeeze the square peg of your patient's information into the round hole provided by the EMR. I miss my fountain pens terribly. The only chance I get to use them now is to make occasional notes or to sign forms. I hope you don't end up hating to show up for work as much as I do.

There is a significant difference between an electronic medical record (e.g., VA's VistA software) and Meaningful Use software (e.g., Cerner). The former is designed around the storage and retrieval of the medical record. The latter is, as you say, designed to aid government and insurance (and even in the US, the government is the largest payer and insurer in health care) in mining patient data. But data mining does have its uses as well, particularly in research -- as long as the information is in a standardized (and ideally open) format.

 

A well-designed EMR has an interface that is or can be designed around the workflow of the practice, physician, or hospital, rather than expecting the practitioners to adapt to their UI. Unfortunately, that's often not the case.

 

As a records technician, I sort of expect physicians to think that as long as the documentation provides enough clues and cues so they can remember and figure out what they were doing with a patient, that's sufficient. What we want is to ensure that the record is accurate, timely, complete, reliable, safe, and easily understood, so that the next doctor or nurse to come along is able to know from the record everything they need to in order to provide safe and effective treatment to your patient. And as medicine gets more and more specialized, the number of other practitioners who need to know what you do from your records is only going to grow. That's where the EMR shines.

[jmccarty3]

Going to be one! ...hopefully (still studying for the MCAT).

 

 

There's still time for you to escape. Get out now, before you waste any more time and money!

[jmccarty3]

A well-designed EMR has an interface that is or can be designed around the workflow of the practice, physician, or hospital, rather than expecting the practitioners to adapt to their UI. Unfortunately, that's often not the case.

 

 

Ya think?

 

I don't care how much IT you know, until you have actually taken care of patients, you have no appreciation for what we are going through. Every specialty's workflow is different, but every EMR is designed for primary care. The tags for symptoms, physical findings, and diagnoses are all from old databases like MEDCIN, so if you try to search for something using current terminology, you can't find it. I'm constantly having to remember what they called something 40 years ago. Even the vaunted ICD-10 doesn't have codes for a lot of what I treat. We're not even attempting to qualify for Meaningless Use--we're just trying to get the patients seen and get enough into the record to avoid a malpractice suit.

 

Everyone talks about how much all this data is going to benefit research, but that costs money, and I'll bet it never happens. The real reason for all this is to get to the point where the software will dictate the treatment that can be given to the patient. When that happens, you might as well be cared for by a robot. The plaintiff's bar will make sure, however, that even though the doctor is not allowed a voice in treatment decisions, he still will be legally liable if something goes wrong.

 

End of rant.