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!
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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 haven’t had many experiences when it comes to electronic medical record advancement. Although, I have noticed in the past few years that there is a growing amount of electronic devises used in medical offices to store patient records. For example, a few years back when I went to the doctor, I noticed a new advancement; there were computers in every patient room. These computers were used by the nurses and doctors as a way of recording every patient visit/recording all relevant information for later consultation.
This advancement was very clever. Instead of having to find my individual file and bring it into the room and then write down all current medical information, the nurse/doctor could simply type all information into this computer which would then go into their database. This method of electronically importing information saves time and gets patients in and out faster, which can be extremely beneficial- especially in a busy hospital
Other than that, I haven’t had much experience with electronic medical records. I believe they can be very helpful because they are easily accessible, but, if the whole system were to go down there would be a big problem. It definitely has made my doctors visits faster and the nurses already know your information before meeting you which saves time as well. It is really interesting to see the transition hospitals and other businesses are making in terms of keeping up with technological advancements.
Lilly,
I am the same as you where I have not had many experiences with the electronic medical record advancement in the ER. However, at Kaiser my primary care physician has converted completely to online documentation and like you, I have noticed that computers now occupy a specific place in every patients room. I see switching to a paperless route as a more time and cost efficient way to go. I find it to be especially useful when I can just go on the internet and log onto my kaiser account to either email my doctor, refill a prescription or access my blood results, etc. However, I noticed that you expressed concern as to the system crashing and the depletion of information. To my knowledge, coming from a family associated in the medical field, they need to do routine back ups and make sure everything is stored on a separate hard drive or device. By doing this they insure the risk of not losing all of their information that was once stored, if for some reason the system or device was to crash.
i have not had any experienced medical care in a digital records (paperless). But i have been in doctors who use advance technologies, and i know the difference between before and these days. In present time doctors have more electronic and advance material then before because of development of new technologies.
Before the processes used was on paper, and comparing to the present time is totally different, because these days doctors use database to store the patient’s information ,so that makes it easy for both doctors and nurses to import and review the patients records. however, comparing to the past, writing the patient’s information on paper might take time and it could be lost any time but using an electronic devices will save time and effort for the users.
In the couple of years since my surgery, I have made many trips to see numerous doctors, technicians, and specialist. As far as I can tell, paperless records have been used the vast majority of the time. There has been a computer in each room, either stationary or on wheels, that the nurses have used to record such information as blood pressure, height, weight, medical history, current medications, and known allergies.
The use of paperless records allows for the quick transfer of information within an organization. For example, the radiation oncologist is able to see the results of a blood draw or MRI that were compiled in a different department. Similarly, all departments have access to a patient’s medical records. However, I have had experience with more than one major health care provider in the Seattle area. Because of privacy laws that protect patient information, one organization cannot access the information of another organization without authorization.
Paperless records have many benefits. These include providing the speed of information transfer, the accessibility to other medical personnel, and convenience for the patient who needs only to supply changes to the information that has already been gathered. Conversely, two catastrophic possibilities are present with paperless records. A system that is infiltrated has the ability to offer large amounts of private medical information. This private information could then potentially become public. Additionally, all paperless records are kept in an electronic fashion. This makes them impossible to access if the system used is unresponsive.
Chris,
I see your point in the ownership of one’s medical records. It is something that we all want to be kept private and yet, be able to be accessed in medical emergencies. I am not sure what the laws are on this particular issue. However, as the use of paperless medical records continues to grow in hospitals and doctors offices, it will be interesting to who gains authorization to certain medical records.
Also, you brought up a very good point. If the system with medical records becomes unresponsive, it may put patients in danger if doctors are relying solely on the system and have absolutely no other kind of medical documentation. As we all know, our computers tend to fail at the worst times. Whether it is during finals week or right before a paper is due, it always tends to happen at the worst moment!
That is a good point about potentially not being able to view the records. In an emergency situation I would hope that doctors have some sort of backup plan. A second system with the records should be used in case the main system crashes. It is scary to think what could happen if someone were to break into these records without permission. Hopefully these systems are very secure to protect us from being victims of something like that.
I am fortunate enough to say that I have avoided any kind of medical office for a good while. Yet in the recent times that I have visited my doctor’s, dentist’s, orthodontist’s and all other offices that relate to the medical part of my life, I can say with validity that their medical records are not completely electronic. Each has used a paper system for as long as I can remember given that I have stayed consistent with each of my practitioners. Granted, all of these offices have access to a computer, one which is more than likely used for practical purposes such as the internet, scheduling appointments, and updating data sources that electronically contain the medical histories of each patient. Yet it is evident by the multiple files on the array of walls that their patients’ medical histories are also stored in paper format, probably for the sake of having a nearby tangible record.
The attention that I have received in each of these offices have always required some kind of attention in which a nurse is required to put a pen to paper and record details particular to my condition. My most recent experience would include my visit to dentist. Here, x-rays were required to determine whether or not I had a cavity. The x-rays immediately appeared on the display screen of the nearby computer. My dentist saved the images to my electronic file yet the dental assistant was still required to record the condition of my tooth into my paper file. This has been a fairly consistent process that I have seen time in and time out during medical visits throughout my lifetime.
It is rational to consider both the pros and cons of electronic medical records. Say my dentist had not immediate access to those images. The technological absence would have reduced the efficiency of him tending to my aching tooth. The pro side of this situation is the opposite of the “con” stated above.
It is a matter of opinion when considering whether or not the pros outweigh the cons in whatever situation one might face. This also depends on how much value we place on one over the other. All in all, technology is ultimately a double-edged sword. There are many positives that can be contributed to technology, such as the accessibility aspect of it. Yet it is for reasons like this that it is an inevitable downfall as well.
Gabrielle,
I hadn’t thought of the privacy laws affecting the data transfer between hospitals or physicians. I suppose it makes sense that the individual would want their information kept private, but it seems fairly strange that medical records would not be available to a current doctor from a previous one. Granted, it would be horrible for medical records to leak to the public, especially for someone with a powerful political position, as I can easily see media personnel exploiting any sort of weakness in people of power, but it would be nice for the consultation i suppose. I was never asked (at least i cannot remember being asked) if i wanted my information available to possible future doctors, and it seems like such a preemptive action would be helpful to many people who see multiple doctors regarding a problem.
Gabby,
Like you I have not spent much time in doctors’ offices lately to have a firm grasp on this issue. Although I have recently gone to the dentist and experienced the exact same thing as you. Having all records on computers would make things easier to access when treating you, but to me it makes sense to have the important records on paper file. I am personally always afraid that technology will fail us at any minute and am all for keeping important things on file in case of such emergency. Of course, like you said there are pros and cons to everything and it all depends on what one prefers.
Last semester, i had to go to the doctor, well, lets be honest, the emergency room, because several things were not going quite right. After some tests, and an ultrasound, it was determined i had an infection and i needed to take some antibiotics. The doctors assistant carried a laptop and recorded the major points of our discussions, which i assumed would be used as a helpful tool when evaluating what was wrong with me. All would be well, i was assured. However, i was to follow up with a specialist in a few days. The doctor that I was referred to was booked solid until December, and in late September, that was a problem. So i went to the doctor next recommended, who got me in the next day. After his diagnosis, which was far less detailed, he determined that i did NOT have an infection at all, and that all i needed to do was take eight advil a day for two weeks. This seemed somewhat odd, because the ER had done actual work. IV’s, blood work, intense pain drugs, the works. Would that data not have been transferred to him, so that he could do a proper analysis? This doctor was sincere, however, that i didn’t have an infection, and so i went on with my life from there. I did have a return appointment the next week though. after my next appointment with him, which was on a tuesday, he told me to come back in two weeks, still no signs of any sort of infection. Well, it seems almost necessary to the story that he would be wrong, as the next night, a wednesday, i was up until three with horrible, mind blowing pain. I decided i needed to go back to the doctor, a hatred for which cannot be expressed in words. I told myself i’d drive, even though i could barely walk. I woke one of my room mates up just so they would be aware, in case i wasn’t around when they stirred for class, and made my way to the car. I made it a block before i was on the side of the road puking. How could it be that these doctors had both given me a diagnosis, yet i was not getting better? (i was still taking the antibiotics, they just hadn’t worked.) I finally made it to the ER, after i disturbed another room mate, my lifesaver. We were there for quite a few hours, and i had a CT scan and another ultrasound. They said the pain was from the infection, loaded me up with synthetic morphine (which was supposed to last six hours and lasted 25 minutes after they unplugged me) and sent me on my merry way. Once again it was an infection. The second trip, however, saw no laptop carrying assistant, and my previous visit was not mentioned. In fact, the prescription i was on wasn’t even brought up. The doctor prescribed some intense pain medication, but that was it.
To make an incredibly long story short, my medical records did not follow me, even when i was picked up and flown home several hours after the second visit to the ER, where i went to ANOTHER specialist. This doctor was incredibly concerned, even when ER doctors thought it was a mild infection and a different specialist was nanchalant about it, calling my ailments nothing more but an inconvenience fixed by an overdose of shelf pain killers. There was a consistency of every doctor, even the ones in the same building, being on separate terms, as if my electronic file was erased prior to every visit. My final doctor, the one at home, wanted to check me into the hospital. I was VERY against that. I went home and the second night i was there we noticed i was hot, i had a 103.6 fever. The next morning i was in the hospital, IV antibiotics and blood tests every hour, surgery, and much much more pain medication. I very vaguely remember emailing my professors, but that could as easily have been a dream. after several days in the hospital, i went home to a weeks worth of IV antibiotics injected by a nurse once a day. After a month out of school, i went back and all was mostly well, but I can’t help but wonder how much easier it would have been if i went to the doctor at home first. The electronic medical records seemed to be there only for a naive sense of security that everything was being impeccably recorded, yet they seemed to never be of any obvious benefit to the situation.
Chris,
That sounds like a terrible experience, and I am so shocked to read that so many doctors were so careless in ensuring your information was transferred to your home physician. That is exactly why going paperless concerns me so much. When people become more dependent on technology, I believe as a result, it may cause them to be much more inclined to adapt lazy and careless attitudes and much less inclined to take a proactive approach to better care for their patients. While keeping records in electronic files without a doubt improve efficiency, I fear that accuracy could take the brunt of it. Hopefully medical personnel will be properly trained in order to avoid such huge errors in the future.
Christopher,
Sorry for your unfortunate situation. Seems like the miscommunication could have been avoided if the various practitioners you visited would have consulted with another ( whether or not this is legal, I have no idea). I can appreciate your closing statement, the one in which you claim that the electronic medical records act as a facade. Your case is special in the sense that I have never heard of medical records, specifically electronic, as not presenting any help to treating an ailment. Granted, nothing and no one is perfect. Yet this is not to say that I don’t understand your skepticism towards the presence of electronic medical records given the pain you endured and the poor medical attention you received. I understand the point of electronic medical records to be used for the sake of efficiency and your case is the perfect example of what I interpret to be an inexcusable failure on the various practitioners’ parts, especially since it seems that the had the technological resources to provide you with adequate attention.
In my experience, I was able to see a pediatrician up to last year and a general practitioner as well. I have been with my pediatrician all my life and even in this quickly technological advancing age, they are still doing everything by hand. However, since she knows me so well, she knows my life long history so she does not need my records. On the other hand, if I go to my pediatrician and it is someone else, it would be easier if they had records on the computer so they would not have to go digging through my files. It would be way more accessible for them.
At my general pediatrician, every room has had a computer since a few years ago. Sometimes, the appointments go a lot faster than my pediatrician because the nurse or doctor types everything into my records.
A disadvantage to the electric medical records is the threat of the computer system being hacked into. This poses a greater threat and risk to the patients because all of their personal and family medical history, social security number, insurance information, etc is recorded in there. This could ultimately lead to identity theft. Also, systems could suddenly crash, so having tangible files is most definitely important to have. However, like I mentioned before, it makes the medical visits a lot shorter and more accessible to the doctor and/or nurses.
Harmony,
I agree it is important to have backup records to augment an electronic database of patient files however, they should not be used as the primary means of backup. Today, hospitals and medical institutions must work with other departments that often are not located in the same building, and sometimes not even in the same city. How could paper files be used in such a situation? In Professor Witman’s case, both doctors were at the same hospital but had the throat specialist been practicing in a neighboring town, an electronic database is by far the most efficient and practical means of delivering patient data. It would allow the patient’s information gathered at the original point of inception to be readily available to the next doctor before the patient even arrives there, thus allowing any receiving preparations to made as well as any precautions to be taken. While both forms of data recording are important, electronic data is the new norm and should be in almost every modern organization.
Harmony,
It was interesting to read your response because you have been able to experience both the paper-focused offices and the technological advanced offices. I too have been going to the same primary doctor for many years but they still pull up all my records every visit and ask repeated questions about my medical history, family history, allergies and other things. I thought that it was great that although your doctor still uses paper as their primary source to gather information, they have found ways to save time and be more efficient. Your concern about computers being hacked is valid and is a major concern in today’s technolically advanced time. However, paper documents are also at risk of being taken and misused. People could simply take them from the doctors offices. You also see paper issues with the mail system. My point is that although medical information can be hacked via computers, it can be also taken and misused with paper documentation. I think that the bigger issue is the threat of computer’s crashing or of the loss of power. The Carr article talked about how the vulnerability factor is key when dealing with IT. He said that “worrying about what might go wrong may not be as glamarous a job as speculating about the future, but it is a more essential job right now”. There are going to be times when technology slows you down, especially in the medical field but knowing how to overcome those issues will be key in success!
Harmony,
I never thought of the implications of having my medical records online. In all honesty, there are many more ways for identity thieves to steal my information than through the hospital. They could hack into my computer which would have less firewalls, blockades, and passwords to crack, or they could open my mail to take out a credit card in my name. Or, if they were really clever, they could manipulate me into giving it to them. There are so many hazards in life, that I think the benefits outweigh the possible consequences. Emphasis on the word “possible.” With everything electronic, it speeds the process, makes having different doctors or hospitals accessing my records far easier than having my paper records transferred, and if there were ever an emergency, they would know immediately that I am allergic to certain medicines.
You bring up the point that if the system were to ever crash, that it would be a huge problem, which I agree with, but with the advancement in technology, I believe that there are preventative measures for that and most likely a backup plan if it did happen.
Harmony,
It was really interesting to read your response because it made me think about the patient-doctor relationship. I also went to the same doctor for years, until she recently retired. Because she knew me and my medical history so well, she didn’t necessarily need my file. We had a very strong parient-doctor relationship and she knew how to deal with whatever sickness I had. Would the incorporation of this new documentation change this relationship? Maybe by documenting on a computer, doctors will not need to take the time to really see the patient as a person. I am in no way against the new technology, but I think a strong relationship is the best thing to make a patient feel safe and trusting of their doctor.
Harmony,
Like you I had been going to my family pediatrician till just a few years ago. They also wrote down all my info by hand and I don’t think there were any computers except for the ones the front secretaries were using. It almost seems pointless the way the doctor would read over the handwriting of the nurse, and then flip through the pages to look at the old medications and stuff, but really it didn’t take all that long. I’m not sure how much faster everything would be if there was more technology used. Maybe places such as family pediatric centers will be able to get by for a while longer by using these older forms of documentation. Until there is really a need for advancement, I don’t want to see my medical costs go up just for new technology’s sake.
I too have been going to my pediatrician for quite a few years now. My doctor it on the older side of the spectrum and feel maybe does not know computers the that well. Since he does not fully understand how use them that he is more like to mess up something on the computer so it makes more sense to stick with old fashion paper. I think a have computer would necessarily speed up the process. If the technology is added how long would it take for every to get used to it and would the benefits out weight the cost?
I totally agree with you in how paperless management of patient’s information and medical history can help save time and better improve doctors’ efficiency in treating and interacting with their patients. If you have to go to another pediatrician without any online/computerized medical background, it would be hard for your new pediatrician to get to know you and take a lot of time for you to reestablish the connection with your pediatrician. On the down side of this, of course, is the problem you have mentioned: stolen information or identity thief. These can be used against patients in many ways, thus providing a secured information storage is also an important part. As your assumption would be something that takes place in the U.S, these potential problems (or maybe already become actual problems) are more likely to take place and at a higher level of risk. To other countries which are following the footsteps of developed countries such as the U.S, these could be a lesson or a warning sign for their future employment of these information technologies.
Harmony,
I agree and you make an excellent point about the speed of the visit. Paperless records do allow for a visit that is much quicker. This is more convenient for the patient and allows the doctor to be more efficient. In theory, the doctor would be able to see more patients per day. Then, he/she would charge less per patient. Who wouldn’t like a less expensive trip to the doctor? As every room is equipped with a computer, the nurse, who is the initial correspondent, has the opportunity to input information that the doctor then does not need to.
I also concur with the disadvantage that you point out. A system of medical records would contain much private information that could lead to the theft of one’s identity. The office of the caregiver is privy to certain information that others are intentionally not. As you point out, others gaining access to this information is a privacy and security risk.
While I luckily have not had any personal experiences within an ER in my life yet, the logistics involved in the type of system described in the article is relevant to many industries. Digital information and the move from paper to electronic data has been one of, if not the most revolutionary transformation in the business world today. The speed and which e-data can be recorded, transferred, and stored is remarkable but that does not always guarantee it is used most efficiently; case in point.
The scenario described in this post reminds me of a case study that I had to work on regarding the company HP and their major internal renovation after the departure of their prior CEO. HP had a successful business model in the past (think old-style paper data logistics in the ER) but wanted to expand into new products. The new CEO brought her new plan to the table that would create divisions within the company that delegated sections of the company to focus on unique products. This, she thought, would allow each group of the corporation to focus on their individual product and ensure its top quality. In the end, what she did not expect was the lack of communication between the groups (like the ER doctor, throat doctor, etc.) regarding the overall mission of the company and the quality of the end result that the customer receives. The loss of a unifying force that tied all parts of the corporation together ultimately led to its stagnation.
It seems that the hospital described above operated in the same fashion. The doctors who first had the opportunity to deliver aid did everything in their power to help Professor Witman and were prepared to record all the data they had uncovered from their diagnosis. However, they did not specialize in the problem he was experiencing and thus transferred him to the proper doctor. One he met with the throat specialist and was given the adequate care, there was no communication between the specialist and the original doctor much like in HP’s case. While there may have been no undesirable outcome in Professor Witman’s case, had the original doctor relied on incorrect information from the patient for another important procedure things could have been much worse.
There is no need for physical data record for patients in such a hospital as the computerized systems available today are capable of being able to store, transfer, and secure this data more effectively than that of a paper-based system. However, there must be proper systems and logistics put into place for these systems to do what they are suppose to, which is to hasten the flow and increase the accessibility of information from any input of the database to another. If every department in the hospital had been setup with a laptop to record the data to a common server available to the entire hospital, the ER doctor would not have had to look incompetent asking those questions, or in a worst case scenario, deliver false data about a patient.
Ken,
I completely agree with you on what you said about no longer having a need for physical data records for patients. There are many advantages to an electronic medical system, particularly those that you have mentioned. I definitely think that offices need to take progressive steps forward in terms of getting the proper systems in place, but I’m not too sure if that will happen as soon many of us would like it to. Not only do doctor’s offices and hospitals need to improve data flow within their own walls (like in Dr. Witman’s case), but each location also needs to get on the same page with one another in order to make this a true success. It will take plenty of time for each office to switch to electronic medical records and to use the same online platform, but it will be well worth it. One of my uncles in Missouri runs a hospital out there and can attest to the countless hours that are required to put every single bit of information about every single patient online. Hopefully all offices and ERs around the country embrace the incentives of switching to electronic data storage and transfer (lower costs for them, ease, accuracy, dependability, and convenience for everyone) enough to begin moving in the right direction.
While I luckily have not had any personal experiences within an ER in my life yet, the logistics involved in the type of system described in the article is relevant to many industries. Digital information and the move from paper to electronic data has been one of, if not the most revolutionary transformation in the business world today. The speed and which e-data can be recorded, transferred, and stored is remarkable but that does not always guarantee it is used most efficiently; case in point.
The scenario described in this post reminds me of a case study that I had to work on regarding the company HP and their major internal renovation after the departure of their prior CEO. HP had a successful business model in the past (think old-style paper data logistics in the ER) but wanted to expand into new products. The new CEO brought her new plan to the table that would create divisions within the company that delegated sections of the company to focus on unique products. This, she thought, would allow each group of the corporation to focus on their individual product and ensure its top quality. In the end, what she did not expect was the lack of communication between the groups (like the ER doctor, throat doctor, etc.) regarding the overall mission of the company and the quality of the end result that the customer receives. The loss of a unifying force that tied all parts of the corporation together ultimately led to its stagnation.
It seems that the hospital described above operated in the same fashion. The doctors who first had the opportunity to deliver aid did everything in their power to help Professor Witman and were prepared to record all the data they had uncovered from their diagnosis. However, they did not specialize in the problem he was experiencing and thus transferred him to the proper doctor. One he met with the throat specialist and was given the adequate care, there was no communication between the specialist and the original doctor much like in HP’s case. While there may have been no undesirable outcome in Professor Witman’s case, had the original doctor relied on incorrect information from the patient for another important procedure things could have been much worse.
There is no need for physical data record for patients in such a hospital as the computerized systems available today are capable of being able to store, transfer, and secure this data more effectively than that of a paper-based system. However, there must be proper systems and logistics put into place for these systems to do what they are suppose to, which is to hasten the flow and increase the accessibility of information from any input of the database to another. If every department in the hospital had been setup with a laptop to record the data to a common server available to the entire hospital, the ER doctor would not have had to look incompetent asking those questions, or in a worst case scenario, deliver false data about a patient.
Ken,
I completely agree with you. In my post I talked about the cons of having physical information and the pros of having the information electronic. When you have physical information on paper, especially in a hospital, that information is going to take up a lot of physical space; space that could be used for much more important things. With the advancements in technology, its important to take advantage of the technology to make business more efficient. By having all the records in a hospital electronic, they are not only able to clear up physical space, but they can also allow that information to be accessed by several people in several locations throughout the hospital at any given time. This immediate access to the information could potentially make the difference between life or death in a hospital by saving the time it takes to access a patients records. This immediate access is important, but the correlation and flow of information between the departments, (in this case between the original doctor and the specialist), is equally important. If hospitals have their records stored electronically, and also the comments or diagnosis by doctors attached to the patients records, a lot of time and physical space can be saved.
When I was younger, I had eight ear surgeries over the course of about eight years (from ages two to ten). Falling victim to bad ear infections seemed to be fairly routine for me. Of course, by the eighth visit to the doctor’s office, they knew me pretty well and even suggested that they hang a plaque on their wall in my honor. Back then, electronic medical records were not at the forefront. All of my information housed at that particular office would have to be faxed to any of the other offices I would visit in the years following. Otherwise, they would not have the slightest clue as to how many ear surgeries had taken place throughout my childhood. As to whether or not these handwritten files have been converted to electronic versions, I have no clue. Since nothing about my ear surgery fiasco has been mentioned by any of the latest practitioners I’ve visited at new office locations, I assume not.
In recent years, each doctor that I’ve gone to has recorded my medical information via a laptop. The last doctor I visited a few months ago had never seen me before and thus did not know much about my medical history. His nurse proceeded to make procedural notes and list information about my vitals on a laptop before the doctor came in to see me. The tail end of the doctor’s appointment was what took the longest because he spent most of the time on his computer — updating my medical information and typing up prescriptions that he would need to print out for me before I left.
He joked around with me while he was doing this, noting, “What happened to the good old days when a doctor could scribble out a prescription on a piece of paper and send you on your way?”. I laughed, thinking about what exactly he meant by this since I assume that laptops had been integrated into their practice to make things easier. The doctor assured me, however, that it did not make things easier at all. Instead, he said, it made the process much more tedious — he’d prefer writing out a prescription by hand. He mentioned that there were now more notes to be made, far too much clicking here and clicking there, and that the actual process of “writing up” a prescription was more detailed and thus much more of a hassle. He continued to share his thoughts with me about this new system they have, bringing to my attention that the problem with the electronic medical records is a compatibility issue. Apparently, not all offices use the same electronic platform for storing information about their patients, making the transfer of medical records from one place to another a difficult task.
All in all, I understand why making the switch to electronic medical records can be a highly beneficial change in the medical world. Notice however that I say “can be”. I use these words because I don’t think that all offices have solidified the effectiveness of this new system. I believe that in order for it to be truly effective, it would have to be “universal”, so to speak, so that all offices would have access to the same information if they need to. Having different platforms for medical information renders the new way of storing information practically useless. In my situation, it makes things “more convenient” for that particular doctor’s office, but how does it significantly benefit me as a patient? What if I suddenly need to visit a different doctor’s office? I think that because it is in its early stages, there are quite a few things that need to be worked out. But it would be foolish of me if I did not realize how helpful and convenient electronic medical records could be in the future. As long as doctor’s offices around the country move towards working through a single common online platform, I’m all for it.
I am happy to report that I have been fortunate enough to not have to experience any emergency medical office in my lifetime. The only doctor’s office I experience on a yearly basis is the dentist and dermatologist. That being said, the medical offices that I do go to have not completely grasped the electronic medical records concept. Each has used a paper system for as long as I can remember. Of course, all of these offices have access to computers, but they are used more for business purposes such as scheduling, and having easy access to important medical records. That being said, the huge wall of filing cabinets consisting of every patients’ medical records indicates that they are very fond of the paper medical records, most likely because they like to have a paper copy nearby in case of a system crash.
Every time I have gotten treated at a dentist, dermatologist, or doctor’s office, there has always been a nurse there to physically write down my medical information. My most recent experience would be when I went to the dentist over winter break. My dental hygienist was able to pull up my x-rays onto a computer but still had to put pen to paper and write down any changes I had with my teeth into my file. Now I know that saving medical records electronically can be both easy and efficient, but there is a great sense of security by keeping physical medical files. It is a safety issue where if something were to happen with the computer system in the office, they have tangible records still on file. Now even though there are pros and cons to every method, it all depends on whether one values one method over the other.
Chelsea,
I guess I have too much faith in storing information electronically, because I never really considered the possibility of a system crash. Even if that were to happen, I’m still sure that the office has the info backed up in a way in which it will not all be lost. I just think that storing a bunch of hard copies, especially in places with a lot of patients, to be a waste of space which could be otherwise used to put another medical machine or anything else.
However, like you have said there are pros and cons to both sides, and there really isn’t a definitive “right” way to go about this, as it’s a matter of preference.
I too have noticed the significant increase of technology use in medical fields in the last couple years. I think that it has its benefits but also can be seen as cumbersome as Professor Witman said in his post. I have seen the use of technology in many different types of doctors’ offices. Personal laptops or ipads were the most frequently used but there were also some offices where desktops were present in every patient room. Technology has made everyday life more efficient and has cut down the time it takes to complete tasks. Time is extremely valuable and the more time you have to do things the more successful you could be.
Technology has made things much more efficient but if you do not know how to use the technology effectively it is pointless. Like Professor Witman, I too have noticed the misuse or confusion with technology in the medical field. For example, when I went into the doctor’s office over the summer to get a simple physical the nurse took down basic notes on an ipad type device about my medical history and information. After she left, my doctor came in and continued to ask many of the same questions and used pen and paper this time. I don’t quite understand why it is that I must repeat myself, especially when it was such basic information but maybe there is some confusion about how to use the devices or is it something to do with patient privacy? I also think that technology is viewed differently across generations. I noticed that my nurse was much younger than my doctor which probably played a major role in the technologies efficiency. Other questions that I have: It is required that the doctor receives the information directly from the patient instead of from the nurse who talked to the patient? This interaction should get much smoother in the next 5-10 years once people become more accustomed to using technology in medical offices.
I have also seen technology being used very effectively in the medical field. This past year I had a MRI on my elbow to check for a more serious injury. After receiving the MRI I went into my orthopedic surgeon to check out the results and see if there was a problem. In each exam room there was a desktop and when the doctor came in he was able to pull up my MRI (from the building down the road where I had the MRI) and examine multiple pictures of my elbow. He was able to use the mouse and zoom in and out on each and every MRI picture. It was incredible. I had never seen technology used in this fashion before but I got a lot more out of the doctor visit because it was interactive and interesting. The visit went well and nothing major was wrong with my elbow but I was also given a DVD of the results to take home. This too was great because I could use the technology outside of the doctor’s office.
Britlyn,
I completely agree with you on the use of our time in doctor’s offices. I get really fed up with the several nurses and doctors that ask you the same questions over and over again when you feel like you should only have to answer the question once. Furthermore, I too had a similar MRI experience this summer with my hamstring. After it was taken, the results were examined very quickly by numerous doctors and I was able to go down to another facility and see my results first hand. It was very beneficial for me since it was like an hour drive away from my house and I think it just shows how technology really is improving the medical field. Like you said, in the next 5-10 years as people get used to the use of technology in the medical field, things will be able to flow a lt faster and you will be able to get in and out of a doctor’s office in no time.
Britlyn,
I agree with both you and Professor Witman about the misuse or confusion with technology in the medical field. I remember when my general practitioner office first got their computers in each room, a handful of nurses took a long time inputting my information. It seemed like they did not know how the system worked yet, which in turn elongated my visit. However, when I went the next year, the visit definitely went a lot smoother and did not take as long. In addition, I also believe that age is a factor with how well they know how to use the computer. The younger nurses I had, did not seem to have as much of a problem compared to the older nurses. In this technological advancing period, I feel that in a few years, people will have to adapt to the current technology.
In my experience, I have found that technology has an increasing presence in hospitals. For my regular checkups, my doctor rarely has paper to jot things down on or look at being that there is a computer in the room where the nurse has already pulled up my files and input the most recent data. It runs like clockwork each time. Any Kaiser that I visit, they have the same record of my past visits, shots, allergies, medications, and all of my medical history. It is nice to see that technology makes the process less complicated and run faster. There were two times I went to the doctor for something other than a checkup. One ran in much the same fashion and I was out of the hospital in less than a half hour. The other time was much longer and far less organized.
I had gone to the emergency room to treat what I thought was chicken pox. They did not pull up my medical records, nor did they send me to a doctor. Rather I went to a surly nurse who had trouble taking a blood sample to check if I had chicken pox. Weeks passed without me hearing of the results online or otherwise, so I called in only to have them transfer me several times to learn that they had lost the blood vial and wanted me to come in again to redraw blood. Why would they ask that if they had taken the sample to check for chicken pox? It was weeks passed and had no relevance now. I believe that they just didn’t record that electronically or otherwise.
Being that I know Kaiser takes things down electronically now, I was a little surprised they had such trouble with a simple blood test. They even called months later asking for me to come in for another blood test. Again, another case of them failing to record the situation properly. Any blood test so far after the incident is a waste of time, which when I had called in should have been clear for them to cancel the order for another blood test. So, in my experience, technology has served to speed and smooth the process in the medical field, but when not used properly, it becomes cumbersome and more of a mess than is beneficial.
Alissa,
I have had a very smooth relationship with the technology used to store information in medical offices as it seems you have more often than not. I feel the use of technology to store information is very useful as long as the information is often backed up in case of a crash of the software. The chance of human error is greatly decreased with the use of technology than with hand written documents, however, there is always a slight chance of human error when the information is being imported into the system, which it seems you have experienced first hand unfortunately. With all being said, I feel the move to a more technological method of storing data will make the medical field more precise and eliminate possible errors that could be made in result of misplaced data.
Like many others here, I consider myself fortunate in that I haven’t had many visits to the doctor’s office. What I’ve noticed on my routine dentist checkups, however, is that now everything is logged into the computer and it wasn’t when I was younger. Now the dentist can easily find out exactly what went on in my last checkup and find out any relevant information. Growing up in the technology age, I think this is great thing to have. While I understand that many doctors, nurses, dentists, etc. were doing their thing before the use of logging information into computers was around, I still feel that it is important for them to know how to log the information into the computers, as it is easier to store the information. This is also more convenient because no longer where there be hundreds of file cabinets holding hard copies of the information of all the patients.
With every year, younger and younger people are entering the workforce, and these people simply grew up in the technological era. Many of these people will think like me: that logging information via computers is an absolute necessity and simply the way to go, and that storing hard copies are archaic and obsolete.
Dean,
I was at the dentist today actually and I didn’t even realize that you are right- everything is done mostly by computers now. When I go to the dentist they can pull up an image of my teeth and look at previous visits to see what happened and what needs to be checked on. I too find this very convenient. They can also access my medical information and see images of any x-rays taken. Additionally, have started sending out text message reminders about appointments, which i find more convenient than phone call confirmation.
As kids today grow up in this “techonology era” they are going to be more accustomed to the new age way of doing things electronically vs. the old fashioned way of not doing things by computer. I agree that because of this there will eventually have to be a switch to mainly electronical information storing because people fifty years down he line won’t know anything else. Although doing things by hand may become obsolete in the future, I think there is still a ways to go before doing things the “old fashioned way” completely disappears. Although many young people, who will be entering the work force, will only be familiar with electronic means of storing information, there are still people in the work force, like us, who were around before that age and may still prefer doing it by hand, or only know how to do it by hand. There will definitely be a switch, i’m just not sure when because there is still a vast amount of older people in the work force who did not grow up doing everything electronically.
Dean,
I’ve definitely noticed the increase of computers for data storage in doctor’s offices. It is a good point that it creates more space, as opposed to dedicating one or more rooms purely for filing cabinets to store patient information that could all be lost in the chance of a disaster. I think it is also important to note that when offices stop using filing cabinets and use computers than their information can be backed up to a second source in case there is a problem at the office. As far as the dentist goes, mine keeps x-rays saved on his computer and looks at the progression of my teeth over the years so there is a clear benefit there.
I myself have not experienced the flow of information in an emergency room first-hand; however, during Thanksgiving weekend my grandmother fell and broke her hip thus needing immediate attention. While on break I visited her multiple times and saw the technological advances in hospital care in the recent years. Every room in the hospital was equipped with a computer; considering the small town I live in, this was impressive. The nurses and doctors, including the surgeon, used these computers quite efficiently to become familiar with my grandmother’s recent medication she had been given. Instead of shuffling through paperwork that a nurse might have used prior to these computers, they were able to easily access any necessary information with a password and a few clicks of a mouse. Also, this makes the transfer of information from one hospital to another or even deferent sections of the same hospital much easier than faxing or mail.
Economically, however, I feel there may be better money efficient possibilities that would lead to the same availability of patient information. The purchase of PCs for every room in a hospital is a hefty cost for a machine that is only being used for the storage of information and possibly the occasional web browsing. Tablets are cheaper than PCs and could offer much of the same features with the addition of portability. The hospital would simply need to purchase the amount of tablets for each doctor and then a network to sync all tablets so they could communicate. This would also save space in hospital rooms that are often cramped for space.
Like most of my classmates, I too have not had many encounters in the ER with the electronic medical documentation. However, I have noticed on my annual routine examinations that my doctor and the associated medical staff use these technological advancements as a way to store all of my medical documentations. I feel that this makes it easy to have access to testing, medicine prescribed, and other consultations that may have been done by other medical personal. Using these technological advancements makes it easier, as a patient, to access my lab results and communicate with my doctor in a more time efficient and cost efficient manner for both parties involved.
It would not surprise me if in a few years it would be mandated for all medical offices to go to a paperless route. It would not only be more cost efficient for everyone involved, but it would be a much easier way to share information. If insurance companies need information before they can completely process a claim it would be mush easier for them to obtain their information if the medical facilities had it stored on file electronically. Therefore, payments for these insurance companies would be done in a more efficient manner. I could only imagine that if you stored such important information on a technological device there would be a compliance rule mandating for the process to back up each device on a regular basis.
Overall, I feel that converting everything to online documentation would not surprise me in the least, with the way that technology is advancing at such a rapid pace. Being able to have your information readily available and have access to any medical information with your name on it and date of birth, could only be a positive effect for the individual in the long run.
Lilly,
I am the same as you where I have not had many experiences with the electronic medical record advancement in the ER. However, at Kaiser my primary care physician has converted completely to online documentation and like you, I have noticed that computers now occupy a specific place in every patients room. I see switching to a paperless route as a more time and cost efficient way to go. I find it to be especially useful when I can just go on the internet and log onto my kaiser account to either email my doctor, refill a prescription or access my blood results, etc. However, I noticed that you expressed concern as to the system crashing and the depletion of information. To my knowledge, coming from a family associated in the medical field, they need to do routine back ups and make sure everything is stored on a separate hard drive or device. By doing this they insure the risk of not losing all of their information that was once stored, if for some reason the system or device was to crash.
Stacey,
I have also taken notice of these new technological devices and new machines to store and take down information on patients. I haven’t noticed any problems occurring with any of these devices, and I can tell how much time they can save the doctors and nurses. I agree with you that this new paperless route will be completely effective in a few years, and that it could possibly be a requirement for all hospitals because of how efficient it can be. In a field where time is vital, I believe that this switch is a necessary step in advancing and saving lives.
Though I have not been to the ER, I actually have been to a doctor who uses electronic documentation. The last time I went was over winter break, and the office was definitely moving toward the paperless route. The nurse brought me back to a patient room and took measurements of my vital signs. She usually would record them into my file, but this time, she entered them into a tablet. Later, the doctor came in and also recorded everything into a tablet. He gave me a request for a blood test, which in the past he wrote down on his prescription pad, but this time he printed it from his tablet and signed it. Later, the nurse at the front informed me that I would be able to view my files, make appointments, and even contact my doctor through the internet site called Patient Ally.
This system seems very new still, and the nurse at the front told me that they are still keeping hard copies on file, but are finding that it is much simpler to use the new technology. Though the paperless system appears to be working, it made me feel better that they were also keeping hard copies. The technology, though cutting-edge, it has not had time to have all the kinks worked out. Can someone hack in and see everyone’s files? What if the system had a virus and everything was erased? Do they have a back up system?
This new paperless documentation will definitely play a part in our lives in the future. This can make our lives much easier, by allowing us to access our records and easily contact our doctor. Being paperless will be space efficient because files can be stored on computers rather than in file cabinets. Further, it is much more environmentally friendly. However, since the technology is young, we do not know what problems may result. Documents must be backed up somehow and security must be strictly enforced.
You asked some very good questions in your response. When Kaiser switched to the electronic records I was concerned about the security of the information. After going through the training on how Kaisers electronic system worked I felt a lot better about the whole process. They explained that the information was stored in a very secure network and there was a back up server in another location incase anything happened to the main server. The law requires that medical records be kept for a certain number of years (I think it is around 10 but i’m not sure) before being destroyed, which also gives patients a little peace of mind. With the proper electronic system, hospitals can easily access, store, and protect the patients medical records.
While I have not had any injuries or illnesses in recent times to require me to visit the hospital, I have taken notice that paper records seem to be a thing of the past, at least for the most part. Very rarely have I seen a nurse or a doctor writing down or referring to a piece of paper for information on a patient. I believe that this switch is a necessary step to improve the efficiency and effectiveness of hospitals. Having to retrieve old paper documents and records can consume too much time, and in a hospital, it can be extremely important not to waste any time. If there is a worry about losing all information on a computer or other electric device, there should be a requirement to have frequent back-ups, and possibly require a print-out of the information just in case the computers were to crash. I think that very soon everything will be converted to electronic devices, seeing as it saves a lot of time and effort in hospitals.
I completely agree with you Matt. I feel as though paperless records will allow nurses and doctors to work more efficiently in hospitals and in doing their everyday tasks. As we are now in the twentieth century, we have seen modern technology benefit many industries. Just think of the benefits self- checkout at grocery stores, and even daily mobile apps that allow you to access information quickly. In bringing this technology to the medical industry, I am sure many people will see the benefits it will bring.
Unfortunately, over Winter break I spent a few visits to my doctor’s office. I became very ill with a cold, that turned into a cough, that turned into a horrible sore throat. Being that this was my doctor’s office, they already had all of my records. This was very helpful because I tend to get sore throats often. However, when it came to prescribing me with antibiotics, my doctor did something different. They were working with a new type of software that allowed them to directly send my prescription to the pharmacy of my choice. This new concept was very beneficial because by then time I had left the doctor’s office and arrived at the nearest Pharmacy, my prescription had already been filled and was ready and waiting for me to arrive. Previously, You would have to take a slip from your doctor, wait in line at the pharmacy, and then wait for it to be filled. This was very time consumer and not the most fun thing to do, being that you are feeling under the weather.
The doctor did not seem completely comfortable with the new system, however, he did not have any trouble with it. This small change to online or recorded documents being sent through a system for medical needs seemed to be very useful. I feel as though doctors should continue to record medical records as online data. That way, in case of an emergency, such as yours Professor Whitman, the patients records can be accessed. It is also very important to know what other medications you may be taking in order to be given the correct care. If someone were not to be in their right state of mind or conditions to state their medications and/or medical history, they are put at the risk of not being given proper care.
Overall, Electronic medical records have numerous benefits. Paperless documentation is an asset to both doctors and their patients.
Christina-
I can relate to your story when you said how irritating it can be to have to wait in line at the pharmacy for an extended period of time waiting for your prescription. I did not understand why it would take so long for the prescription to come into the pharmacy and why you could not pick it up at a place of your choosing. I think that new prescription pick up is an easier way to get your prescription without any hassle. I agree with you when you say that having all medical records online has numerous benefits and I think that more medical offices should start to transition to having all their medical records, prescriptions, etc. on line and easily accessible.
I do not have too much experience with going to the ER or doctors offices but I do go a couple times a year for checkups and injuries. I too have noticed an incredible increase in the amount of technology that is being used. I remember years ago when everything was written down and filed away and each doctor would have to go searching through a bunch of files to find out the right one about you. Now, at least in my doctor’s office, there is a brand new laptop in every room and each nurse/doctor is carrying around an Ipad with all the patient’s information on it. When I have gotten checked in the past year, my appointments go extremely faster then they used to because it only takes two clicks of a mouse to pull up all my information and it takes down the time used to ask all the questions that have already been put in the computer. What I found was interesting in my last visit was that my doctor was able to send my medical prescription from her Ipad to the pharmacy in about 10 seconds time. It just goes to show you how incredible technology is becoming.
However, I think the problem with the technology boom that doctors are experiencing is that not every doctor/nurse knows how to use this type of technology yet. This then leads to why a lot of patients are dealing with the questions from the doctors that could be easily answered if they looked at the medical records on the computer or Ipad. I do think, however, that the communication either in the ER or doctor’s office needs to greatly improve. I do not think I only speak for myself when I say that I get fed up with different nurses and doctors coming into the room and asking you the same questions that the previous one did. I get tired of repeating myself and if they were to have a little bit of communication, not only would they be able to speed up the time of the visits but the doctor’s office overall would become more efficient. Overall, I really think that technology is greatly improving the ER and doctor’s offices as a whole. There are obviously still things that need to be improved but I believe they are right on track to becoming even more efficient.
I have experience with the electronic medical records. I have Kaiser Permanente as health care coverage and the company no longer uses paper charts. Instead they have a system called HealthConnect. I also used to work for Kaiser in the Chartroom and Admitting Department. While working in the chartroom i saw the process of coverting from paper charts to the online system. I then transfered to the Admitting department since the chartroom was being closed down because with everything in an electronic system there was no longer a need for paper charts. I was trained on how to use the HealthConnect system so that I could admit the patients and fill in and verify their basic information.
I found the electronic system to be overall easier and more efficient than the paper charts. It makes information more easily available for the doctors and nurses. The HealthConnect system is protected and uses its own network in order to secure. It also limits the acess of employees so that they are only looking at the information that they need to. This way the receptionist who checks you in for your appointment doesn’t have acess to you actual medical history since it is not information that they need for their job. The system is pretty easy to learn with the proper training. If proper training is provided and exam rooms and patient rooms have computers, the doctors are able to access and record information quickly with out it getting lost or filed wrong. There is still room for human error with the system but it has decreased the amount of possible errors that could have occured if the chart was paper.
Crystal your response is very interesting and it is awesome to see a perspective from someone who experienced the transition first hand. I agree with you on the efficiency of the new system for the doctors and the nurses as long as they learn to use it effectively. The HealthConnect also sounds like a really easy and effective program for Kaiser to use and implement and with this program the questions of patient privacy and security seems like it is less of a problem. And I also agree that the chance of human error is always possible but with a computer that is also to reduced and even if there is an error in the information inputted it would be much easier to fix with a computer instead of restarting a whole new chart or crossing something off.
I have experienced the newer technology of online medical records after a recent surgery. It makes going from one doctor to another much easier since everything can be sent to specialists and in my case certain rehab places so you do not have to keep telling every doctor what is wrong and what happened to you etc. With everything though there are pros and cons, the medical world is a little slow in going to a digital information setting since they have for a long long time kept every patient record in hard copies. So the transition to the digital medical records requires new training for the doctors, nurses, and receptionists that are working in the hospitals and clinics.
However with everyone becoming more comfortable with this new way of keeping records it increases the efficiency of your visits to the hospital which speeds things up and saves money. The other cool thing about online records is that they can more easily be updated in real time. For example in cases of a bad accident the EMTs on the ground can digitally send a report to the hospital so the doctors expecting the patient(s) can more easily prepare. There are problems though as with every network and maybe even more so in a hospital setting, it is imperative that the network is up 100% of the time and that is difficult as many things can go wrong with computer networks and if a doctor is unable to access important information about a patient because there is a hangup in the network it will not be a good thing.
All in all though it is about time that the medical world transitions to keeping records online as it is easy and efficient to keep all of the patients information in a nice and neat database that can be accessed just as easily.
A few months ago my younger sister was admitted to the emergency room after a soccer injury. Her ankle was shattered and she was in severe pain. She arrived extremely late on a week day and was there till the next morning where she was then transferred to a local hospital. While I was not with her upon her arrival to the Emergency Room, I did join her shortly after she arrived. Much to my surprise the podiatrist that was on call did not show up in a timely fashion. In fact it was not until around 2 in the morning that he made his way to her bedside. She had already been given an IV from the nurses.
It was a bit strange to see that with all the technology going on in her room, the nurses still communicated via white-board. She had a computer on stand next to her bed as well as a monitor tracking her heart rate, ect. Yet when a nurse would enter the room she would look to either me or my parents to see if anyone had been in to see her since she last checked. Also, when a nurse had to administer necessary medications, she would record her actions both on the white-board and a file which hung on the back of her door, and same with the next nurse and so on. This process did not seem that effective in my opinion.
Like Professor Witman stated in his blog, what if the patient could not have answered for herself, or her family members were not in the room? Would the nurses and doctors know what was going on? Would she be able to get the necessary treatment as promptly?
I have to agree with Chris. I think the use of paperless records has its benefits. It is definitely more effective in getting your local doctor your medical records from offices/hospitals farther away. However, I think that in order for paperless communication between nurses, doctors and other hospital staff to be effective their needs to be a more efficient system in place. Perhaps these people need a special “app” or a separate smart-phone like device that they use when on shift. The fact that information can get to another person or multiple people quicker with technology is obvious it’s just a matter of developing a functional system, as well as continuously updating their ways so the information is transferred as hurriedly as possible.
I haven’t been to a doctors office in about three years so I haven’t seen much new doctor’s office technology. However, I play sports and many of my friends play sports meaning they have frequent injuries and surgeries. One of my closest friends has severe shoulder problems and has required four different surgeries on them since I’ve known him. He is from Arizona but now goes to school at Penn. His latest surgery was in Pennsylvania and I assume information from previous surgeries was given to his new doctor. Electronically sending this information form Arizona to Pennsylvania is obviously the easiest way for a doctor to acquire the data accurately and in a timely manner.
Having electronic medical data could potentially make situations like this much easier. But if a doctor were to not review this information I’m assuming that could have bad consequences. I could see this as an opportunity for doctors to get lazier and hopefully that isn’t the case. With access to electronic medical records doctors could be more informed, and more efficient than ever. Hopefully they use this advantage as best they can, and not let the advances in technology go to waste.
Last year I experienced some swelling in one of my shin muscles that pretty well blocked off circulation in the nerves going to my foot, making it almost impossible to even raise my foot. This had happened before, but never quite to this extent (Later found it to be swollen scar tissue from old soccer injuries). I went to one of the local places here in Thousand Oaks and got it checked out. The man who was examining my leg was typing information into a computer. The information he was entering though was very generic, not specific to me at all. The entry system he was using reminded me of the programs used by Auto-body shops. The kind where the tech puts in the required info: make, model, year, piece, etc. He struggled with this for about 5 minutes while trying to make it someone seem more personal to my actual problem. He then called up another document, and actually wrote in what the condition seemed to be. This was then sent over to the next room where they would continue to look at everything.
To me this whole process seemed like an extreme waste of time. What was meant to simplify a medical examination only increased the duration of the exam itself. With a pen and paper he could have easily jotted down little notes here and then about my situation but instead seemed locked in by the limitations of the program. I think that electronic medical records had countless benefits in today’s world, especially as hospitals and clinics become larger with huge patient populations. There is now no delay in sending a record from one part of the hospital to another, or even to another hospital all together. It also eliminates the possible misreading of messy handwriting. But it seems as though technology has not quite gone far enough to fully eliminate the usefulness of written documents. Maybe now with electronic tablets becoming more common and advanced, this will serve as a form of compromise between old and new. Either way it is important for the medical world to focus on what works, and not just what seems to be the modern thing to do.
Hey Kevin,
Sorry to hear about your experience. It sounds like you dealt with some physicians with outdated technology and in your case it seemed to be almost a waste to use it at all. My experience with electronic medical records was much smoother and I think that electronics actually may have helped in my case. Maybe as technology improves and clinics continue to update there equipment there will be a trend towards technology being more useful. Hopefully if you ever have a similar experience you will get to see the other side of electronic records.
A few summers ago I had an experience where I had a staff infection in my foot. I had seen this sort of infection before so instead of going to the doctor immediately I attempted to treat the infection myself for a few days. Not surprisingly this was not the best course of action, and only a few days later I found myself going to my local doctor to get my foot checked out. Sure enough the infection had gotten much worse and started to spread up my leg. The doctor electronically recorded his findings on a laptop and rushed me to the ER. I arrived at the ER within 20 minutes and i was almost immediately given a room. The doctor at the ER was able to retrieve the information from the earlier doctor immediately and within a few minutes had fixed most of my problem in my foot. I was amazed with the responsiveness of this system and was very pleased with my experience.
Clark,
It sounds like in your case, electronic medical records were very useful. This brings me to my thoughts that in more emergency type situations, quick knowledge of records can make for an fast fix to the problem. I think that if used properly and in emergency type situations this type of record holding can potentially save a person’s life by providing necessary information to the doctor’s. I think this has great potential. I do however think that there are times when it is unnecessary and almost wastes more time. Mr Witman had to repeat himself to various people and it seemed like there was a little disconnect between the technology use and the methods of actually using that technology. Maybe since it is a newer concept, medical offices should have training sessions on how to effectively use the new technology. This way it is more integrated into their everyday practices.
Recently I have been fortunate enough to not have to go to any emergency rooms but as I recall from my past yearly check ups, dentist and optometrist visits not all of the information gathered is electronic. The doctors still come in to the patient room with a file of all the previous appointments, medical issues and other information dated from when they first started going to that specific doctor. I go to Kaiser at home and I know they are starting to do some of their appointment recaps on the computer that is in the patients room that is connected with the rest of the office, but I think that is mostly a recent thing. If I remember barely 10 years ago there were no computers, and if there were none of the patients information was on them; they were just used for scheduling appointments. I have been in emergency rooms in the past and from what I do remember it was very irritating having different doctors coming in asking you the same questions over and over again.
I think that the use of electronic records would be more beneficial so if you had to go see another doctor they would not have to rely on the patients word or call the previous doctor for information, it would be right on the computer. An issue with that is how it would be kept on the internet and who/how would have access to it. Also, some people may not want their information out there for everyone to see, so if a system like this were to be used then I think each patient must give their consent before it could be used by various doctors. I believe though that with the increasing technology age and more and more companies are starting to only use technology, I think that the medical field will soon have to make the commitment to shift as well. It will take a very long time because they will manually have to fill in old reports, but in the long run I think it would be more beneficial to have that technology on hand everywhere you go.
Kirsten,
I agree that implementing electronic ways of gathering patient information would greatly reduce the redundancy of some doctor visits. I personally get annoyed when I’m asked the same question by various doctors, and now they would all have access to the question I answered the first time, which would allow them to all be on the same page. As for the question you raise about security and patient consent, I do not find that to be all that concerning. Everyday people trust the internet with their finances and other sorts of personal information without hesitation. Using paper, the all of the clerks and medical personnel could potentially steal your file, however if we were to protect those files with passwords set by the doctors, only those who had need to view them would have the power to.
Kirsten,
I agree with just about everything you said. I definitely think that people will have issues with their medical records being available online. It seems very against the standard, doctor/patient confidentiality that I’m sure we’ve all come to know. I think that as time goes on, and more people become comfortable with the very open world that we live in, as well as the technology that is being discussed that most will decide to release their information. We can only hope that it will only be used for the right purposes and that the information will be safe.
I think that doctors need to have back up of your medical records, other than keeping your information up and on a comupter. If the computer system doesn’t respond or work when your in the er room, you will be in a mess of trouble. Having a back up will make it alot easier on the doctors. This will be so because they won’t make mistakes if they have another record of it on file. Back Last February, I went in for a routine checkup, turns out it was a little more cumbersome than first thought. It turns out they had to remove a lymphnode from my chest. They lost my test records when I was transferred from the ER. It took them 2 hours to find them before they could perform the surgery. It was very inconvienent for me to be waiting a while to have my surgery because of lost records.
Kirsten,
I agree with you. Having electronic records would speed up the process when you have to go to another doctor. But security of these files is very important. They would have to be kept securely on the computer so that no one woul have access to them except the doctor perform the procedure of checkup on you
About a month ago i was taken to the ER due to a loss of consciousness while playing a basketball game down in San Diego, Ca. As medics rushed me into the ambulance, I had noticed a couple monitor screens and some electronic devices. In my visit to the ER prior to this one, the medic handed me a clipboard to fill out, which seemed quite inconvenient. This time around while I was watching the medic strap padding around my arm for blood pressure, i found that a digital keypad was placed in her lap instead of a clipboard. The medic asked me questions about my health along with my recent activity. Following those questions, my answers would be typed into the keypad for records. I believe the keypad was used to record my basic information and current health status so that the hospital could move more efficiently in their process.
I would figure that if there was a way to receive all patient information through a simple fingerprint scan, the ER could run a lot more efficiently than they do today. The trip to the hospital could be used to help with the needs of the patient, and questions asked during this time could be based on health related issues rather than requesting background information that could be done through a fingerprint scan. More diagnosis considering the patient’s current injury could help the ER prioritize procedures along with the speeding up in processes.
I totally agree with you on having better access to patient’s medical history. This would save a lot of time as well as reduce chances to giving false or risky treatment to patient. If we can develop a better data storage or records of everyone who has been to a hospital before, doctors and nurses won’t have to spend extra time asking patients questions about their medical backgrounds. This is particularly more important if the patient is unconscious or unreliable in giving background information. Inconvenience for the patients and inefficiency for the doctors are the other two possible reasons for this.
I have only really had one scare as far as emergency rooms go. I have bad circulation and sometimes my body tenses up and spasms. I usually can take care of it on my own and essentially wait it out however I have ended up in the emergency room for it. In my experience, the use of computer generated medical records could have proven to be very useful.
I was not in my hometown as as such I ended up in a hospital that I had never been in before. when my parents brought me in I was still unable to really say or do anything on my own. It took them awhile to even place me in a room, I was out in the waiting room for quite awhile while I was still having spasms. They said that they were unfamiliar with my history and as such were unable to make a quick diagnosis. I can’t help but wonder if my records were in a secure file somewhere if they could have quickly looked it up and known how to respond more quickly and effectively.
Luckily my parents were able to tell them what was happening and my history with bad circulation. If I had been with someone else this might not have been the case.
It seems that in these types of circumstances, electronically generated medical records can come in very handy. In the ER often there is no time or ability to ask about a person’s history or find the necessary charts quickly. However, it seems in Mr. Witman’s case they can just be an unnecessary effect to attempt to keep up with the times.
I believe that there is a time and a place to which these can be beneficial but they should not be applied to all areas in the medical environment.
I really liked your submission because it touched on the basis of how it might seriously be benefitial to give some hospital or doctors office your name and/or social to punch in somewhere to retrieve your medical history so they may be fully updated on what previous medical care you’ve recieved without a two-hour long recap in such events as needing immediate medical care and/or you are incapacitated. In that sense, I feel it would be highly beneficial for patient information to be digitized. However, I agree that there is a time and place for this sort of thing. I raise again my former argument: how do we keep this information from flowing into the hands of the unwanted?
What’s to keep any doctor with access to this information from retrieving it at will without the consent of the patient. What if there were some way to require a patients’ password to access the information like phone and electric companies do? But that may be a long shot. If any of this were possible across a large network there would have to be implementations that restirct unwanted users and a broad range of limitations, which may complicate the process further. Whew! Is it worth it?
I believe the use of digital medial records, while being an adaptation of the new era, could certainly prove to replace less efficient paper methods of patient information and processing. However, nothing about your article suggested to me that this process was made simplier by the use of digital patient charts. Your description still sounded like there were about 15 different people to see you that day, (which is typical in any doctor or hospital visit) and when the doc came back in after the ST and asked for a recap of events…if all the information of your visit were recorded digitally, why wouldn’t he know all of this prior to his return?
Suppose the process could be made easier without paper charts and all the doctors and nurses would carry around iPads and from anywhere the could update patient information immediately; it would be nice but with serious attaching concerns for me. What site or server would they be using and how private would that information remain. If there is a specific application that stores information about a patient that may be different than say a clinics website that stores patients’ information because the former would raise security concerns for me. Wouldn’t it be more likely that the information entered about an individual be easier for outsiders to gain access to? Wouldn’t it just be like entering in information a patient into a site that any doctor, nurse or other clinician could type in a password and retrieve? How do you secure that kind of information?
Normally I do not go to the doctor very often, but I am beginning to witness a rise in the use of electronics and a move towards a paperless file. I remember as I was entering high school that when the nurse placed my file on my doctor’s door, it was beginning to get to the point where it would not fit in the file holder. I can only imagine how fast someone’s file who frequented the doctor grew. It is becoming easier and easier to store information on electronic devices. Not only does it cut down on paper costs, but also we can store millions of patient records in the space that 1 patient’s paper file takes up.
I feel a move to a digital doctor’s office is a great decision. It will better the environment, and will make keeping track of patients easier. Before a doctor had to page through a long medical file to look for a specific date, or illness, but now with the file being on the computer he or she could type in a few keywords and be brought right to the spot he or she was looking for. While there will be a small learning curve for the doctors to become used to the new system, in the long run, the positives will outweigh the negatives.
Tyler, I agree with your statement and that the use of electronics in the medical field will cut paper costs, and is just an easier and more efficient way to store medical information. My recent experience at the doctors was one of the easiest ones i’ve had and that was mainly due to electronic access of my medical history etc. It saves space, time, and hassle of overflowing medical files. With the world we live in today it makes sense that the medical field is taking a more technological approach.
It also makes it easier to tranfer informtion from one doctor to another as it did for me. It saved me from driving from one city to the next to have to pickup paper work or have to worry about dropping it off thrn coming back later for an appointment. I broke my hand and wrist about a month ago and avoided seeing a doctor for as long as possible because it’s always such a hassle. I hate filling out the same paper work over and over and having to wait or come in 30 minutes early to fill out a ton of forms. I think it’s great that doctors are finally using this more updated approach and I think it will show to be much more efficient in the future.
Technology in the workplace is always advancing, why should a doctor’s office or a hospital be any different? Over time I think that having medical records online will turn out to be a very useful thing. As facilities and doctors make the transition into this new process though, I assume it will be quite stressful and seem cumbersome to a doctor who already has a large patient load (as many ER doctors do). While I do believe in the advancement of technology, I think in medical facilities that are large and fast-paced, a clip board at the foot of a gurney is more ideal for the time being.
Take a place like UCLA hospital, a massive multi-building facility that specializes in all different kinds of medicine. If a patient moves from the ER to an operating room and then quickly again to a room where they can be monitored, isn’t it easier to have something that can be filled out easily on the move, and that is always attached to the bed? Not to mention that it’s a hard copy and thus is more reliable than intangible and new technology. When the technology is “perfected” and ready to be used in a fast paced setting, I hope that it is. I personally don’t think that time is now (judging from the experience with the doctor above).
Addison, I agree with many of the comments that you have made. Technology is bound to change the way that offices work, and their capabilities. You mentioned that one of the major problems with technology is that it must be mobile. What about having a tablet (like an iPad) that was attached to the gurney and traveled with the patient to show live, up to date information on their file? I agree that the idea of hard-copy paper files seems less risky, but I think that the faster technology is implemented, the faster the kinks will be worked out and, in turn, the more efficient medical establishments will be able to become.
Ever since I came to the U.S, I haven’t got into any kinds of accidents, thus I have not been at any hospitals or clinics. While I can’t truly examine your situation in particular and others in general at an U.S hospital, I believe that being able to transform hospital workplace into a paperless environment is a great thing. Opposite from the U.S, have you got in accident in Vietnam, it would take you a much longer time to have everything checked up. Even when you go to a very modern and up-to-date hospital in Vietnam, it may only have all the important modern machines that are crucial for saving life. Being able to transform the whole information system between doctors and nurses (and probably between other members as well) is a great step as it greatly reduces the actual time it takes. If the efficiency of the system is much lower and less effective like it is here, doctors would simply cut out all the examinations and tests that he thinks not likely to be necessary, or at the margins of safety protocol.
Taking your case in consideration, I would say the doctor was either saving times or simply wanted to check on your current status. Since people’s lives here are much more appreciated and valued, such carelessness as to ask a patient what the other doctor said about the problem wouldn’t occur. I may be wrong in your case, but nonetheless, I still believe that the general picture is like what I said. In addition, having an online records of your health over the year, or after every time you go to a hospital, is a great thing! It would save so much time in diagnosing as well as reduce the risk of false treatment. The more a doctor can know about his patient’s health history, the better and more effective he can be. Only a paperless system can help do this.
In our society today, technology is advancing, with new technologies coming out every day. All businesses, including hospitals have come to rely more and more on these advancing technologies just to keep up. These new technologies have helped these businesses operate more efficiently and allow for much easier access to information. This is especially true with tablets, smart phones, and other mobile devices that have networking capabilities.
When I was in high school, it was required to volunteer a minimum of 100 hours over the 4 years of schooling. I chose to volunteer at the local hospital, Three Rivers Community Hospital. While volunteering in the hospital, I was located in the Radiology department. Aside from taking mobile X-Rays, printing out X-Rays, and working along side of the technicians, I also helped out in the filing area. When I first began working there, all of the patient files were paper files. It took up a lot of storage space, took a long time to locate the patients’ files, and these files could deteriorate over time. We had a flood at the hospital when a water pipe broke, and some of these files were destroyed. Shortly after this happened, all of these files were transferred to electronic copies. This made it easier for the technicians to access the patient files and helped make their work much easier and more efficient.
Bryan,
Helping your local community by doing community service at the hospital was very niice of you. Not only did you help the doctors but gained an experience not obtainable to many high school students. Your lucky to see technology in a hospital become more up-to-date as you worked there. I enjoyed reading your insight to innovation at the Three Rivers Community Hospital. Maybe someday it will be useful and give you an edge in todays competitive employment pursuit.
During this past Christmas break, I unfortunately broke both my hand and wrist. I went almost a week without seeing a doctor because I thought it was just a bad bruise/ sprain. Well, I eventually went to a nearby urgent care, which is a brand new. The doctor came in with a laptop instead of a file and sent me to an office next door to have x-rays done. This urgent care had many different offices in the building but it was all through los robles hospital. During the x-ray process, I was asked a few questions and they were able to access all of my information and medical history including past visitations to the local hospital from many years prior. By having my information already on file, I was asked to make sure all my info was up to date and didn’t need to fill out a bunch of forms. I was also asked to sign an agreement which was on a touch screen not paper. After the x-rays, I was sent back to the same doctor where he was able to pull up my x-rays on his lap top after just minutes of having it done. The entire process took about an hour and that even includes having the cast put on.
Despite the bad news of having 3 broken bones, I had a good experience at the doctors. I think that having to fill out less paper work and the doctors having access to my medical history made the whole experience quick and easy. The doctor from urgent care ended up sending me to a specialist because of the severity of the break and recomended a few in my area. When I saw the new doctor he had access to my x-ray pictures through the computer, which saved me from having to get new ones or the hassle of going to the previoius doctor to pick them up. I think that there are a lot of benefits to having online records including the easy access for new doctors to view important past medical history. It also saves patients time like it did in my experience and overall it’s just an easier, more organized and faster process.
As technology progresses, I have noticed an increased use of computers in the medical field. Every time I am at the doctors there are desktops mounted on mobile carts in each room. After a nurse takes my vitals they enter the information into a computer. After the doctor comes in he updates my medical records by asking me the same questions each visit. Even in the emergency room, my information is entered into a computer. But entering this information into a computer is not where the use of technology stops in medicine. Engineers are always working on developing new and innovative technologies. They have created equipment such as Magnetic Resonance Imaging (MRI), ultrasound, and blood sugar monitors. These extremely useful tools among others are used to analyze problems, create solutions, and overall save lives.
I believe the use of electronic medical records is becoming a necessity in today’s world. Going paper-less with medical records would increase efficiency and protect individual privacy. For example, if you need to go to a hospital while abroad, doctors from any other country could quickly access your records and know your medical background. With knowing your historical information on medications or allergies, they can better relieve your symptoms. Furthermore, by only having electronic records, individual privacy is better protected. Only doctors would be able to access your records without the chance of some unknown individual getting their hands on old hardcopy records. Technology is constantly making our lives easier and more efficient; the real question is where should it stop?
Luckily, it has been quite some time since I have made a visit to the ER or even the doctor’s office (knock on wood). Thus I cannot describe any experiences with the swift evolution of technology and its permeation into the medical realm. The only example that I can think of deals with a recent trip to the dentist, where a new x-ray machine allowed for a faster process. The new machine displayed the results immediately on a digital screen rather than in a printout form. I thought that this experience was very positive because the less time I spend in the dentist’s chair the happier I usually feel as I leave.
That experience in mind, I can imagine how technology will eventually greatly enhance the medical experience overall through increased efficiency, transfer of knowledge, and better care technology overall. Professor Witman’s story highlights some of the hiccups that can occur when processes change, which is a natural occurrence, coupled with changing systems that have long been in place. The story got me thinking of ways I thought that the process could be improved to smooth over the transition. My main suggestion would be for the doctors to have tablets (such that the iPad) rather than laptops, as they are much easier to carry around. The tablet could take place of the paper files that the doctor would customarily check before meeting with each patient, making the process better for the environment and easier when it came to the filing of the documents, as they would be organized electronically.
I am excited to see how technology will continue to better the medical industry, and hope that the transition towards technology is one that smoothens its kinks out quickly as to avoid costly or tragic mistakes.
Bjorn,
This seems like a good idea to make tablets that can access these records. The only suggestion that I would have for that is if the companies that make these tablets create a seperate category of the product that only doctors would be able to purchase and access. It would also be good to increase the privacy/accessibility of the actual tablet. I am not entirely sure about the security of typical tablets, but it would not surprise me if someone could find a way to access a stolen device. To avoid people who want to steal records, the tablet should have some sort of fail safe so the info cannot fall into the wrong hands.
Roy
Throughout the years, I have been in medical environments that have paper records. When I first heard about online medical records, I thought that it would be extremely beneficial to the medical community. However, I did not have a chance to experience the paperless phenomenon until my senior year in high school. After tearing my meniscus during football, I was referred to an orthopedist. This doctor was the first I had ever seen to not carry a chart, but instead a tape recorder and an electronic chart. It was a surprise to see this because I was used to doctors or nurses asking me questions and filling it out on a paper chart. I actually found it refreshing because this doctor is adapting to an increasingly paperless world. This might be due to his desire to be more efficient with patients. In reality, I met with the doctor four times and only talked to him, collectively, less than ten minutes. Although there was no personal interaction, I did like the fact that the staff did not have to waste its time by digging through old records.
Although there might be people who are worried about privacy, I find that these paperless records can be extremely beneficial. For example, if I was, hypothetically, deathly allergic to a specific antibiotic and I was in a foreign country and needed emergency treatment; this would be able to save my life if I was not able to give the information myself. I find that it would be far more beneficial for me to have this information on hand because of the time and effort it can save. Also, it provides me with a sense of personal security. I do however believe that we need a fair amount of privacy and security when it comes to these records. I am personally not worried about what people may be able to see on my medical records, but others do have the right to feel secure when they give confidential information to a trusted medical employee.
I can say that now my personal care physician has decided to switch to electronic records. However, I have not seen him personally access the information. I have only seen the younger nurses use the programs. I hope that every doctor will be able to use this system soon due to the increase in the world’s technological capabilities.
Sounds like a very unfortunate injury. Although I have not experienced any recent personal medical care in a digital records environment for humans, I have for my animals. I have had a couple ER visits for my dogs recently and I feel that the digital record environment put slight ease to an already stressful situation. In times of emergency visits (most of these visits are unplanned) it allows the patient (in my case dog owner) to feel more confident in the care being provided knowing that the veterinarian has a full history about your dog. Most of us don’t enter the ER with full records in hand or for that matter can remeber the last time vaccinations were administered and so forth. In times like these, digital records stengthen medical practice allowing for better accuracy and healthier patients.
The ER I attended was not the location I take my dogs for routine check-ups. However, because the ER was affiliated to my primary veterinarian my dogs records were readily available for the ER vet. This would have not been possible without the technological advancement of digital records and IT systems. Furthermore, when I attended the post- op with my primary veterinarian, she was completely updated with the ER veterinarian notes, care performed, and digital x-rays. This made my work load as the patient (dog owner) effortless.
I feel that online medical records have a lot of potential and the benefits are increasingly surprising. Most dogs now have a chip inserted behind the shoulder blade when they are licensed with the city. Once this chip is scanned, the city can pull up the owners contact informtation and some medical records about the dog. Much like the hosptial band that is worn around the wrist of every patient admitted, these tools are key to utilizing the advancements and strengths of digital records in medical practice. The barrier between the technological advancements in digital records and the benefit of the patient is simply the practitioner. As seen in your situation, the doctor chose to not utilize the system which automatically caused the patient to switch thought of who was advocating. Was he not using the process of the ER to access and review records online because it does not retain the same efficiency he got while using his scribe to record information? Or was this a common issue we see in organizational behavior in regards to a division among older generations and technology?
Roy,
I agree that digital medical records give patients a sense of security. In emergency situations especially, it puts an individual at ease knowing that if anything should happen, and you can’t be fully there to advocate for yourslef, your records are readily available. When it comes to ones health and well being, accuracy and timing is crucial and digital records fufill both those needs. Digital records make it possible for vital information to be exchanged quickly and efficiently.
When assessing whether or not electronic medical records and files are the best way to go, I believe it is important to take a look at the result of Dr.’s offices going paperless. As far as my experience goes I can testify that the length of time it has taken at my Doctors visits have significantly decreased, especially time spent waiting to be seen. I think that the electronic method has certainly helped to speed up the process of getting patients in and out in a timely manner. Instead of having to waste time by creating a new hand written file or chart, nurses are able to take down notes much quicker with the use of electronic documents. Although, the shortened Doctor visits are wonderful, it made me begin to think they were becoming much less personal, now that my information was being transmitted into a computer.
This makes me wonder, how and where does this information go? Since nurses and Dr.’s have begun depending on electronic means of recording patient info, it makes me question exactly how much care do they take in terms of keeping it stored safely and correctly. Although it appears that this process would make life easier for all, it seems as though this might in fact make medical offices more careless. Since they aren’t keeping track of a tangible file, my info may be lost in a different folder on the computer or may be sent to the trash accidentally. While I definitely feel that the electronic records improve time and efficiency, it feels much less personal and much more like I am just another document saved in a sick or healthy folder on a nurses desktop.
Similar to a few other students, I luckily have not had to make a trip to the Emergency Room recently, so I don’t have any experience to share in that area. However, I have had numerous check-ups with my personal doctor and here at CLU’s own Health Services. From my experience, I have found that the use of laptops to record information has become helpful in a time-saving aspect, but it also creates a barrier between the doctor and the patient. More than once, I have been asked questions by the doctor and have looked back at the doctor to answer them, but find that the doctor does not look up once from their computer screen. Instead, they busily type away everything I’m saying ( at least I hope that’s what they’re doing ). I’m not trying to bring down the use of technological advancements such as laptops during office visits, but I do feel that they way they are used by doctors can be seen as off-putting. Has anyone else had similar experiences ?
As for Dr. Whitman’s experience, I completely understand the confusion and surprise that you felt when you were asked to report on your own doctors visits, and I wish I could think of a way that patient information could be transferred even more quickly than it is today. Still, I think that the main reason why your doctor asked you for the answers instead of reading them for himself is due to a major time constraint that doctors are always facing. The way I see it, the doctor could have stood outside your room and reviewed your file before walking in, but he may have felt that it was easier and more beneficial ( maybe since you were conscious ) for him to ask you personally. These days, doctors end appointments and move directly to the next, so I’m betting that he felt it was more important to have face-time with you ( even though it makes him look less professional and organized ) rather than to catch up with your file on his own.
Elizabeth,
I can definitely relate to your experiences at the CLU Health Services center. As an athlete, we are required to go in once a year to get cleared for our sport. You bring up a good point about the “barrier” between the doctor doing the exam and the patient. The problem with technology and computers, especially, are that they can be distracting and prevent communication from flowing easily. As a patient, you would like to sure that you have the doctor’s undivided attention so that he or she can respond and address your needs and concerns. This easier and more efficient method of keeping patient files may be more helpful to the doctors and not to the patients. There are a lot of sides to this issue so thanks for addressing this one!
Lauren
I have been quite fortunate thus far in my life with regards to the Emergency Room so I cannot exactly compare my experiences there. However, I have noticed the increase in the use of electronic patient files and documents at my dentist’s office. Since my family moved to California in 1998, the dentist offices we have gone to contain computers in the examining rooms. It’s amazing to see how technology has advanced to this point. The computer is able to save information from my past visits such as X-rays, actual pictures, and panoramic models. The process of saving this information is clearly a positive strategy for the dentist’s office because it reduces the amount of time that patients need to be in the examining room. Happy patients mean more referrals which is crucial in the field of Dentistry.
In a broader sense, patient files on computers can also have disadvantages. Even though it takes the average human less time to type than write, there can be problems with computers. Servers can go down, hard drives can crash, documents can be lost, you name it. This is not to say that there is also a likelihood of fire or water damage to the place where physical patient records are kept. However, the risk of losing files on a computer is much greater. As noted in the blog post above, you wanted the confirmation that the doctor had actually looked at your physical file and not just your electronic file. This is why most medical services either have all physical files or both physical and electronic files so that there is no question about the traditional form of keeping a patient’s information.
All in all, I see great potential in the future of keeping patient records. As long as all of the kinks can be worked out in the computer realm, then there most certainly could be a gradual shift to electronic files completely.
Brittany,
I agree with your thoughts on the questioning the safety of having your own personal file being sent around on the internet. Since we won’t be able to track where our files are being sent, we really have to be trusting of the employees who are viewing and sending out information over the internet. Nevertheless, there must be some way that files are sure to be saved from being deleted, such as a back-up drive or something similar. I also shared the same concern that the increasing use of laptops during office visits contributes to a much less personal visit. Instead of being a visit, it is more of an exchange of information. Although these files do make patients less tangible and seem more detached, I have to admit that using files to keep track and send medical records does seem to be the most time efficient manner of staying organized in today’s world.
My experience in doctors office has been that the only computers are the front desk which are used by nurses. I have not seen any computers in the of the patient rooms before. I have not noticed not very many technological advance in the use of computers in any of the doctor’s offices I have visited. I have been lucky that I have never had to go to the ER, so I have no experience with what they use. I know that my doctor’s can transfer information to another doctor very quickly with very little difficultly. When my doctor comes to do the check up he still use paper sheets fulled my information. I notice none of the nurses use computers when taking my measurements. I feel that maybe the reason my doctors don’t see the benefit to using a computer when they having been doing it the same way for years with works for them. That the doctors are older and may not be very familiar computers which would make it a hard transition for them.
I have not have not had much use electronic systems for offices, but can see so of the advantages and disadvantages of using a electronic system. Some of benefits would be less human error can be made because that machine does most of the work. Can be more efficient because it regulates itself and does on others. Doctors and nurses would be easily able to search medical history which will speed up the appointment. Information is less likely to get misplaced or lost if is in the computer. So disadvantages with computers is if the sever goes does down they can not receive any information which could slow down or completely stop the appointment. Also making an error computer tends to be less noticed because people expect the information already be right and it would make it harder to find out what is what is wrong because they would check other things before they checked the computer.
Greg,
I think it is interesting to point out that older doctor’s will not want to switch over because they are not as computer savvy as younger generations. However, this situation may turn out like the DVD vs VHS switch. At first there were those skeptical or too frugal to buy a DVD player and did not switch over. But just like the VHS, we are leaving hard copy files in the past (or at least were trying to). Depending on how long before retirement they have, these doctors may go a few decades trying to keep up with those offices who have switched over. While we may not be ruling out paper entirely, using paperless files is becoming a transition that can improve patient visits by reducing wait time and making the process go by more smoothly. I agree that there would be less of a chance for hings to be lost or misplaced. If something gets filed under the wrong person in a hard copy system, it will be impossible to find again unless you know whose file you acidentally put it in.
To be very honest, I have never been to a Doctor in the United States( Quite fortunate, since I have been here almost 3 years). The last time I visited a doctor was back in 2005, when I had fractured my hand. Since technology was not very common in India back then, I remember that the Doctors relied more on files and paperwork.
Even today, I don’t see a big change in technology(when it comes to patient records) and I do not foresee it in the near future. The only difference is that we used files to store records back in the day and we use databases today. I am not very surprised since the procedure used is just the same. Quite similar to how we used the encyclopedia back in the day, but we use Google today. the only benefit(that I have noticed) of using databases is that it makes it much easier for the doctor to access records. Databases may have a few disadvantages as well. For example:- Labor might cost more, since it is cheaper to hire a clerk to do your paperwork than hire someone to manage databases).
Pointing out to Lucas’ point that medical records could easily be accessed by Doctors in other countries. I don’t think that it is anything new. We have had fax machines since a long time and records could be accessed easily even if they were on paper. I definitely not against technology. I am totally aware that technology has saved a lot of lives. I just believe that we have not made a lot of progress when it comes to handling records.
according to Siddhanth Samtani point view, i disagree with you in this part when said “Databases may have a few disadvantages as well. For example:- Labor might cost more, since it is cheaper to hire a clerk to do your paperwork than hire someone to manage databases).”
hire a clerk to do the work might not be good and efficient as the labor. because we are looking for the quality of the work and time. so that can be done by people who are more familiar with technologies more than paper work.
And I also agree with Lauren, that servers can go down and hard drives can crash( Having several backups of a big hospital could be costly.) Basically, there are millions of things that can go wrong even with the best technology. So it is always important to store hard copies and not forget how it was dealt with in the past.
Moreover, paper can be recycled, so it will not do the environment a lot of damage.:D
Regardless of a paperless system or not, I have still had to wait a long time in doctor’s offices. But, this has given me the advantage of observing both an environment of paperless files as well as hard copy patient files. One of the medical offices I visit still uses hard copy files. The girls in the front are working around the clock with these files: asking people to update forms, putting labels on them, and getting them in order for the doctors to have on hand when it finally is your turn. They spend a lot of time preparing these files and I believe that it accounts for the longer wait times I experience at this office. The doctor can’t see you until your file is ready, and that can take a while. On the other hand, one office I visit uses paperless patient files. While in the hard copy office it is easy to see that the women in the front are working on patient files, it is impossible to know what they are working on in the paperless office because they are on computers (Unless of course you try to ask them). They could be doing the same type of prep as the hard copy office, but either way it seems to be a faster process. Getting prescriptions filled is also a lot easier at this office. The doctor uses the laptop in the room to send your prescription to any pharmacy you want. Most times, it will be ready to pick up if you go right after leaving the doctor’s office. This takes out part of the hassle of dropping off your prescription. Also, an rticle I read on this made a very ggood point that this eliminates handwriting errors (Swiech October 08, 2010). I was never able to make out what my prescription said and I always wondered if the pharmacy ever had to call and double check. However an equally important point is that typing can allow you to make a lethal mistake very easily. 20 and 200 are very different numbers in the medical world, so if overlooked it could be drastic. This new information technology can be viewed in many ways but it seems to have a positive effect on the doctor’s office experience.
Swiech, Paul. Pantagraph, “Electronic file system a boon for OSF doctors.” Last modified October 08, 2010. Accessed January 24, 2012. http://www.pantagraph.com/news/local/article_d4600630-d344- 11df-9620-001cc4c03286.html.
Wow – a citation of another article to go with your comments. Good show!