I have just come home after working a fourteen hour day as a nurse. And at least an hour or more of that day can be blamed on electronic charting.
The government (Medicare arm) decreed that hospitals and clinics must go to electronic medical records (EMR) about fifteen years ago. According to http://www.ehow.com/facts_7501089_medicare-emr-guidelines-regulations.html, “In other words, doctors and hospitals who fail to convert to electronic medical records and to make meaningful use of those records will no longer be able to seek Medicare payments for their medical services.”
About twelve years ago, we had to implement an EMR system in our clinic. Trying to gather the information needed when a patient came to the clinic, and enter it into the computer, (time yourself writing a blood pressure reading on a piece of paper and going through 4-6 screens, each time hitting enter and typing systolic and then diastolic separately and see which takes the longest), added about an hour to each nurse’s day. Hence, more pay, higher health care costs. And has anyone noticed the reams of paper now used just to give you a report? My medication records from the mail order pharmacy come often and with a sheet saying, “This page has been left blank on purpose.” What a brilliant idea.
Recently a friend began counseling. The counselor typed everything into a computer as they talked, never once making eye contact with my friend during the counseling session. My cousin says a physician she loves and who had great rapport with her in the past, now sits watching his computer screen through much of their visit, and she feels as if the computer is actually a barrier between them.
I got free groceries one day. Walmart only does electronic checks and the computer froze up, the clerk hit the reset button too many times causing a very long delay in it resetting itself, and after 15 minutes they took my check and let me go, and never cashed it! I got another free product worth $26 at another place of business as their computers went down.
My husband was delayed for five hours from transferring out of an ICU because the physician grabbed the wrong template of orders to fill out in the computer. Five days later, he was delayed five hours in being discharged from the hospital because the computer system crashed and they lost the discharge orders. I could tell more stories, but you get the picture.
I love computers for research, word processing, email, social media, and blogging! But, as I rest my tired feet and frustrated mind, I would gladly go back to paper charting, having time to be more engaged in face to face contact with my patients, having records easy to access right in front of me instead of clicking and searching through 3 to 6 screens and then maybe not finding the information I want, and the ability to cross out a mistake, initial it, and not have it permanently scribed on an electronic record that I can do nothing about because I closed the chart before I realized I had made a mistake in charting!
Expensive EMR systems, with choices that don’t fit the situation in the pre-written charting so we can qualify for payments, are not my idea of progress. And I sure don’t understand why they didn’t ask me first, before the country started this “great idea”!
I’ll write my next post when I haven’t worked a 14 hour day, and maybe it will be more like my last one when I wrote of being on the mountain top!
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