Computer Charting and Me

105182105411111CDPby Neva Bodin

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 know a doctor who had his staff running to his office when they heard a crash, only to see him picking his computer out of the trash where he threw it in a moment of frustration.doctor computer

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.Hammerd

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!

http://www.nevabodin.net and Facebook

 

Advertisements
This entry was posted in communication and tagged , , , . Bookmark the permalink.

12 Responses to Computer Charting and Me

  1. I’m fond of saying that -puters are like spouses. You can’t live with them. You can’t live without them. Happy -puting.

    Sent from my iPad

    >

    Like

  2. erinfarwell says:

    I used to be a health care consultant and I feel your pain. I hated telling clients they had to do something less efficiently or practically then they wanted because it didn’t fit the government-required standards. Great post.

    Like

    • Wranglers says:

      Thanks Erin. I thought younger nurses, having been indoctrinated in training, would be less frustrated, but they eventually become disenchanted sometimes too, probably every time a new program is implemented. Aw–for simpler days. Neva

      Like

  3. sstamm625 says:

    For everything we’ve gained with computers we’ve also lost something it seems.Electronic records were supposed to make things easier, right? I’ve got to say, I’m shocked that a counselor would type notes while with a client. That feels to me like a violation of the counseling relationship…. Great post, Neva!

    Like

    • Wranglers says:

      I think you got it right about gaining and losing. And it doesn’t always seem balanced to me. But it’s what we have, and I am shocked also. I have interviewed many clients, mental health and otherwise, body language and eye contact are so important in gaining rapport and credibility. But with so many texting and “facebooking” now, I am told some people are not the best at being interviewed for jobs because of lack of practice in 1 to 1 engagement! Interesting how things change! Thanks for comments.’Neva

      Like

  4. Doris says:

    When we changed to a computer system at the state level over thirty years ago, it was to save paper. When I retired, we not only were using the computer, but three times as much paper to back everything up. The use of computers is only as good as the programer has made the program. As a counselor, eye to eye and true connection are the key to progress..oh well, they say computers are progress. I can understand your frustration. Doris

    Like

    • Wranglers says:

      I’ve certainly noticed the increase in paper also, even at the store with long sales receipts with more information than I’ve ever wanted! I think most people who use computers in business situation have some of the same issues. I call computers the “constipaters of society.” They slow everything up. But then I try to see the upside…
      Thanks for comments. Neva

      Like

  5. Nancy Jardine says:

    I’m also shocked about the counselling session you mention. I’m sure that would be horrible for anyone, Neva. Sadly, I don;t think the Health service in Scotland (my area anyway) is properly ‘joined up’ regarding compouter record keeping. In 2013, I had a minor operation in the hospital 17 miles away but last month my doctor’s surgery didn’t seem to have any record of the blood pressure checks from the hospital visit on my local Patient File on their computer. Just as well I’m borderline.. I hope I’m borderline… I think I am. 🙂

    Like

  6. Mike Staton says:

    I have to admit though, when my medical computer records for the doctor and his clinic in Wilmington can be accessed by whatever doctor I choose to go to in Henderson/Vegas, it could be a good thing. I’m just not sure if the two clinics’ computer systems can talk to each other. I know that when I was still a reporter and interviewed local hospital staff about their computer system upgrades (they were part of the East Carolina University Hospital system), I learned they couldn’t talk to computer systems of systems not part of the ECU system. I thought they kind of defeated the purpose. It’s like an electric grid system that’s not tied into surrounding regional grids.

    Like

  7. I can really relate to this post, Neva. Having recently been in the hospital, one of the things I disliked was the time spent “computer charting” by those who took care of me. I would much rather have had more time to explain how I was feeling. However, I know change happens and should make one’s job easier. I think we all have a love/hate relationship with the computer. Yes, it’s faster and can do things we never dreamed of, but I actually think it takes more time. When I was in the hospital in Mexico the nurses were dressed in the white uniforms with the caps on their heads and did all charting by hand. They took time to sit and talk with me to be sure they were doing everything possible to make me more comfortable. I suppose one day they’ll go the way of the computer too. Ah, progress!

    Like

  8. sj says:

    We all seem to have a love hate relationship with our computers. Often what is meant to be more efficient tends to be more time consuming. I agree with you that before large scale changes and requirements are put into place the people that are most affected by those changes should be consulted. However that rarely happens. I generally blame the glitches, and quirts of a new system on some guy sitting in an office somewhere that never has to actually use the system he designed or implemented. I would like to meet that guy one day.

    Like

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s