Tuesday, October 15, 2013

Bring on the Bad Language....

My office is one the last in our organization to switch to fully electronic medical records.  I've been hearing the complaints and moans of my colleagues for the past two years as the change has been implemented.  I've taken my Mom to her doctor and watched him carrying her 20-pound paper chart on his little mobile computer desk.  It's easily three times heavier than his laptop.  I haven't seen him open it for any reason - I think it's just a security-blanket kind of thing.  And even he has begun to admit that once you get the hang of it, it's a good idea.

We've begun.  For the last month all of our prescription renewals have been handled online.  It's lead to some interesting mistakes, none thus far harmful.  Prescriptions meant for local pharmacies have gone mail-order and vice versa.  Medications whose doses have been adjusted but not recorded in the medication list have come back to haunt us.  I've been frustrated to be partially trained.  I can renew a prescription, add a problem to the problem list (the computer insists that I should have an actual REASON to be writing a prescription, imagine that!) but I can't check to see when I last saw the patient or view their most recent lab reports. 

This week we "go live".  I have a ton of training time, and based on the experience of other offices they've cut our patient load from 5/hour to two.  I expect the learning curve to be steep and ugly, and the Bad Words are already flying.

In the long run it will be a very good thing.  It will increase accuracy, decrease the number of times I write a prescription only to discover that the patient's insurance won't cover it.  It will tell me immediately if a procedure requires prior authorization.  And each 'chart' will be completed before I even leave the patient's side - no more waiting for transcriptions.  And I'll bet the spellcheck will let me use the word 'colonoscopy' without suggesting that I really meant 'kaleidoscope'. 

I've seen how the electronic medical record makes things simpler for Babygirl when we go to CHOP.  They know her medications, her pharmacy, her history - it's all at their fingertips.  I've watched them create graphs of lab values to follow trends (something I've had to do by hand for my patients).  I've seen how her kidney doctors know, less than 20 minutes after we've seen him, what her neurologist is planning to do.

Here's what makes me sure I'll make it:

If my mom's doctor, ten years my senior and firmly convinced that Barack Obama himself personally looted his retirement fund, can figure this out and make it look like a good idea, anybody can.  I can handle this.

Just remind me to wash my mouth out with soap before you talk to me in church on Sunday.


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