True story, with some (potentially) interesting implications –I recently spent some time in the emergency medical system, and got to see some of the benefits and foibles of electronic medical records. Some of it was great! But other parts gave me pause – I’m interested in your experiences.
In December, I suffered what turned out to be a minor injury. During an exercise with one of my volunteer groups, I was doing a training exercise that involved falling and allowing the members of the group to catch you. I had not (in hindsight!) fully trained my group, and when I was falling, I ended up falling into the hands of a single individual. He did his best to catch me, but was unable to do so (not his fault!), and as I fell I struck his knee with my throat.
That blow took my breath away, and made my voice increasingly hoarse. Since I only have one airway, I thought perhaps it would be best to get it checked out to make sure it wouldn’t swell shut during the night J. My local urgent care clinic looked briefly, and immediately referred me to a nearby emergency room, as they didn’t have the tools to check it out. The emergency room (where I went post-haste) was excellent – conducted a brief triage (but got no real information from the original clinic), assigned me to a bed in the ER, got me seen by a doc pretty quickly, and then scheduled for a CT scan. There was a PC in the room that the nurses, the phlebotomist (who inserted an IV line in my hand) and others used to record what had happened with me thus far.
When the doc came through (pretty quickly, I thought), he brought a scribe with him. Turned out she was a local college student, studying to be a nurse. Her task was to enter data on my case on behalf of the doctor – a nice compromise which allowed the doctor to focus on me and my case, and not pay attention to a laptop. I suspected that it made the doc’s time much more efficient.
Then things got interesting. They took me away to run a CT scan on my throat, and brought in a throat specialist to run a scope in and look at my vocal chords (the structure most likely to have been damaged). The CT scan was delivered electronically to my records, so the throat guy could review it. He arrived very promptly (all things considered, since they brought him in from home on a Sunday night), checked things out, and prescribed a medication to be given intravenously (good thing I had that IV in already).
Some time later, the original ER doc came by to check in on me. In the pre-digital era, that would have involved him looking at my paper chart to see what had happened with all of his orders, and what the other doc had found. But not this time! Turned out that he asked me for a recap of events – had I seen the throat specialist? What did he say? What did he prescribe?
Now I suspect that if I had been unconscious or less than fully functional, he might not have used that approach. But it struck me as odd, and perhaps indicative of an issue in the ER. Perhaps the process for the ER doc to access and review records online is cumbersome? Perhaps there’s not an easy way for the doc to review patient info while retaining the efficiency he got while using his scribe to record information?
And that, of course, led to questions. What could be done differently? Is there some way, other than a laptop, that an ER doc could use to efficiently access patient information? Was he trusting my report of the information to be complete and correct, or did he go back and review the actual records later? (I assume he did, but have no way of knowing for sure.) In a more holistic way, could the original clinic have put information online in a medical record that could have been accessed by the ER doc directly, to reduce the friction in getting me into the ER system?
Have you ever experienced medical care in a digital records (paperless) environment? Have you seen anomalies that surprised you? Have you seen the benefits of those online records? I’m interested in your experiences!
True story, with some (potentially) interesting implications –I recently spent some time in the emergency medical system, and got to see some of the benefits and foibles of electronic medical records. Some of it was great! But other parts gave me pause – I’m interested in your experiences.
In December, I suffered what turned out to be a minor injury. During an exercise with one of my volunteer groups, I was doing a training exercise that involved falling and allowing the members of the group to catch you. I had not (in hindsight!) fully trained my group, and when I was falling, I ended up falling into the hands of a single individual. He did his best to catch me, but was unable to do so (not his fault!), and as I fell I struck his knee with my throat.
That blow took my breath away, and made my voice increasingly hoarse. Since I only have one airway, I thought perhaps it would be best to get it checked out to make sure it wouldn’t swell shut during the night J. My local urgent care clinic looked briefly, and immediately referred me to a nearby emergency room, as they didn’t have the tools to check it out. The emergency room (where I went post-haste) was excellent – conducted a brief triage (but got no real information from the original clinic), assigned me to a bed in the ER, got me seen by a doc pretty quickly, and then scheduled for a CT scan. There was a PC in the room that the nurses, the phlebotomist (who inserted an IV line in my hand) and others used to record what had happened with me thus far.
When the doc came through (pretty quickly, I thought), he brought a scribe with him. Turned out she was a local college student, studying to be a nurse. Her task was to enter data on my case on behalf of the doctor – a nice compromise which allowed the doctor to focus on me and my case, and not pay attention to a laptop. I suspected that it made the doc’s time much more efficient.
Then things got interesting. They took me away to run a CT scan on my throat, and brought in a throat specialist to run a scope in and look at my vocal chords (the structure most likely to have been damaged). The CT scan was delivered electronically to my records, so the throat guy could review it. He arrived very promptly (all things considered, since they brought him in from home on a Sunday night), checked things out, and prescribed a medication to be given intravenously (good thing I had that IV in already).
Some time later, the original ER doc came by to check in on me. In the pre-digital era, that would have involved him looking at my paper chart to see what had happened with all of his orders, and what the other doc had found. But not this time! Turned out that he asked me for a recap of events – had I seen the throat specialist? What did he say? What did he prescribe?
Now I suspect that if I had been unconscious or less than fully functional, he might not have used that approach. But it struck me as odd, and perhaps indicative of an issue in the ER. Perhaps the process for the ER doc to access and review records online is cumbersome? Perhaps there’s not an easy way for the doc to review patient info while retaining the efficiency he got while using his scribe to record information?
And that, of course, led to questions. What could be done differently? Is there some way, other than a laptop, that an ER doc could use to efficiently access patient information? Was he trusting my report of the information to be complete and correct, or did he go back and review the actual records later? (I assume he did, but have no way of knowing for sure.) In a more holistic way, could the original clinic have put information online in a medical record that could have been accessed by the ER doc directly, to reduce the friction in getting me into the ER system?
Have you ever experienced medical care in a digital records (paperless) environment? Have you seen anomalies that surprised you? Have you seen the benefits of those online records? I’m interested in your experiences!
- Electronic Medical Records – how will you access yours?
- Facebook as your single password on the Internet?
- Funky PR stunts & identity fraud
- Collaborative Writing in the Bus Com Classroom
- Social Media Metrics and Analysis
True story, with some (potentially) interesting implications –I recently spent some time in the emergency medical system, and got to see some of the benefits and foibles of electronic medical records. Some of it was great! But other parts gave me pause – I’m interested in your experiences.
I have had several encounters with electronic filing and data recording in medical environments. I believe that if used correctly it can be very beneficial but when executed poorly, it just leads to less enjoyable visit. My first encounter with electronic data logging was with a stomach specialist I was seeing. He actually had his lap top out with him and was typing up everything I was saying. I did not approve of this approach because it left me feeling dis-attached to the doctor. If the doctor is the only recording the information then he is paying less attention to the patient. It was an awkward environment talking to the doctor while he was starring into the computer screen.
My second encounter with electronic filing was much more pleasant. Over the summer I had two trips to the UCLA emergency room. The first visit was for several broken knuckles. The process was fairly simple I gave a nurse all my medical information and she entered it into the computer as I told her. Following that the doctor came in with a print out of what I had told the nurse and he had already gone over it. I believe that is the best solution to multiple doctors coming into the room and having to read reports there.
My second trip to the ER was even more simple than the first. Although I was brought in for a completely different purpose (allergic reaction), they still had my information saved from last time. So when I got in they already knew which types of medication I could receive and we didn’t have to go through the patient sign in process again.
For about the past six months I’ve had some minor health problems that have required semi-frequent trips to my doctor’s office. My doctor does everything digitally. Even my initial paperwork was filled out online the day before I had even stepped foot in the office. Like others said I usually have a nurse update my information and symptoms in a laptop before I see my doctor, however it is kept out while I see him and he often refers to it throughout my appointments. For example, in my last appointment he used it to pull up multiple images of my last procedure while explaining to me what everything meant. He also used it to instantly order a refill on my prescriptions to my new pharmacy that I picked up later the same day. I have a patient portal with him where I can view results, prescriptions, set up appointments, update my patient information, and even receive emails from him between visits (not that I’d really want to). I understand the concern of privacy, but practically I’ve really enjoyed the simplicity and eco-friendliness of my online record, especially with how often I’ve been to his office lately, my papers would have to be updated as soon as they were printed! There have been a couple times I’ve visited a specialist besides him and having the records transferred back and forth quickly between the doctors seemed to help keep things in order. I’m sure there are definite downsides to online records but so far I’ve had a good experience.