Physician whose mother had heart surgery reflects on sane EHR use

The following from a physician I know, an ED physician, on the care their mother received at a major academic medical center's teaching hospital using EHR.<br /><br />Emphases mine:<br /><span class="HOEnZb"></span><br /><blockquote class="tr_bq">Mom just had aortic valve at hospital [name redacted] associated with [redacted] Medical School.  EHR used was [major EHR vendor name redacted] but it clearly had been pushed into the background......<br /><br />1) Every ICU patient also had a <b>printed chart in a notebook (paper) medical record book </b>kept at the nursing station.  Just like the old days. <b>It was the most commonly used source of info to the residents and staff.</b><br /><br />2) <b>Not once did I see an EHR physically come between a patient and a staff member</b> (as opposed to <b>nearly every encounter</b> where I work).<br /><br />3) Mom's (and every ICU patients) plan for the day was outlined in magic marker directly on the glass doors and windows and updated during rounds...<b>.available for immediate reference, not buried in an EHR.</b><br /><br />4) Her clinical info was accurate....... it was <b>dictated and not fabricated from pick lists</b> or dot phrases.<br /><br />5) <b>Clerks put in the data and Dr's orders</b>......apparently they long ago figured out the nonsense called CPOE and let the clerks do it.<br /><br />I suspect many major University hospitals h<b>ave worked around the workflow barriers and most egregious documentation sins.</b>  The doctors there (at least in that Cardiothoracic ICU) have enough clout that they can just say HELL NO.  Those of us working for less astute/ non cutting edge community hospitals run by "also ran" healthcare corps are left to bear the crosses ONCHIT and the EHR industry have dumped upon us.<br /><br />I am grateful to the folks at [hospital] for an excellent job on my mom and demonstrating <b>that efficient healthcare pushes the EHR (as currently sold and configured) to the back burner.</b><br /><br />Oh, [EHR name redacted] still is loaded with those prefilled templates and copy/ paste pull forward geared for upcoding.....but these "top of the food chain" docs just didn't waste their time with them.</blockquote><br />Having had to gut and remediate really, really terrible health IT for invasive cardiology and cardiac surgery years ago (<a href="http://cci.drexel.edu/faculty/ssilverstein/cases/?loc=cases&sloc=Cardiology%20story">http://cci.drexel.edu/faculty/ssilverstein/cases/?loc=cases&sloc=Cardiology%20story</a>), and revise workflows to relieve busy clinicians with critically-ill patients from the stupidity and time-sink of fiddling with balky computers with poorly-designed software, I identify with this physician's observations and beliefs.<br /><br />As I've stated in previous posts, most clinicians need to be relieved of clerical tasks associated with computers, especially data entry and ordering, not just surgeons.<br /><br />If the data is really that valuable, hiring clericals to do clerical work should remain a true bargain, with massive return on investment.<br /><br />If that is not the case, then the data is really not that valuable.<br /><br />-- SS<br /><br />

Physician whose mother had heart surgery reflects on sane EHR use

The following from a physician I know, an ED physician, on the care their mother received at a major academic medical center's teaching ...

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