Wednesday, January 19, 2011

An MD hospitalist on EHR's: I might have inadvertently skipped something during the mayhem

At "Clinicians Going for a Swim and Drowning in Information" I commented on a NY Times article about how information and cognitive overload can lead to deadly consequences in warfare. My implication was that medical care (e.g., the ED) bears some similarities.

I received this reply from a clinician hospitalist I know, who also is well versed in Medical Informatics:

Wow, great piece, but a little too close to home for me right now.

Eerily similar to / descriptive of my experience last night in the hospital: processing multiple information sources related to multiple different problems for a new admission (patient, family, ED staff, disjointed EMR - some documents in the Documents tab of the [major EHR vendor name redacted - ed.] system but most others in the hospital system Portal requiring a separate lookup, some radiology studies available through the EMR on any workstation but others requiring accessing the PACS system directly on scarcer dedicated workstations - plus paper record components, including EKGs, progress notes) ... all while various drone-equivalents are channeling information regarding multiple other admissions in the wings and/or patients decompensating on the floors or in the ICU.

Oh yeah, and then there's the "12 hour shift" thing. Oops, gotta run... Just slept all day after my night shift and have to head back to hospital for the next one. Still haven't submitted any charge tickets, btw, even for last week's shifts (I'm carrying around paper face sheets with scribbled notes on the back; I'm supposed to fax them to the billing office once I figure out what CPT / visit intensity code I want to use.)

Gosh, I hope I remembered to touch on 10 bullet points related to ten organ systems for my ROS for each of my admissions; might have inadvertently skipped something during the mayhem...

PS. I'd love to be wearing one of those brain wave contraptions mentioned in the article to see what my theta wave activity was.

This is not atypical of IT's effects on healthcare today.

-- SS

1 comment:

Anonymous said...

This description is that of most doctors using these devices on the front lines. Physicians desirous of providing the care of which they are capable are disrupted and impeded by the user unfriendliness.

After experiencing hours of bombardment of the cerebral cortex with photons processed from an overstrained occipital cortex, the ability to focus cognitive energy on other tasks is disabled.

There is evidence that this disability may develop permanence.