EMR, an exercise in mental recall or perhaps in my case, it's an exercise in mental relapse. I have to admit it's been awhile since I have experienced such frustration to bring me to tears, but finally I succumbed this week. My husband's encouragement to me to keep on persevering is that "at least I won't get Alzheimer's!" This has been the second week of seeing patients with our new electronic medical record system. I have longed for us to have this system for many a year, especially as the practice had been bogged down with gigantic paper charts and had become so cumbersome with endless paper trails. We were always hunting charts with non-ending requests for refills, labs, x-ray reports, etc., etc. . . Several times you found yourself even repeating those tasks with other staff. Certainly, EMR would be our answer. . .
It is, I still believe, but what a learning curve to climb! It's amazing the technical advances that are at our fingertips, that all our medical history can now be kept in cyberspace. I am beginning to adjust to listening and typing my patients' present needs. It feels somewhat awkward as I want to still maintain my attentiveness to them despite the square box that sits between us. I realized yesterday that I must learn to think like it does. After all, it's really just an exercise in repeating the same commands. Of course, the challenge is to recall or remember the path to take that will give me the result I'm wanting. And it's consistent to the point of being unforgiving, you cannot stray from how it wants to take your information in.
The biggest issue is coding visits. I love our health care system in the good ol' USA. Every diagnosis has a number assigned which is attached to how much insurance or Medicare will pay. There really is no common sense to what the diagnosis is really called or what category it could possibly be found under. Diagnoses that have always seemed quite straight forward now have other possibilities that you must seek and find. Of course, if you don't have a number to insert, you find yourself trying to find it with a word or two. And don't forget to code for all the procedures you do or the shots you give, plus there's codes for all your history and your family's history too! We love numbers in our world, we have one to identify that we truly do exist and all our medical history now can be reduced to just a numbers game too. I guess numbers in means dollars out, but remember the dollars never come back into your pocket. No, it really is just a way for the insurance companies to ration health care and justify their existence, all the while insuring that their pockets stay lined with gold. . .
The nice feature of e-prescribing stops the busy task of handwriting prescriptions that at times end up lost and have to be redone. Yet, even that involves a series of steps that for now seem easier and quicker to go ahead and write out the prescription. It's the same thing with signing off lab and chart reports, all of that builds up in my "jellybean" of tasks, with daunting numbers---my present highest 24. Those reports use to be just stuck in a drawer that I would get to as I worked throughout my day, but now I see them ever before me and growing. Yes, I'm learning to sign them off with my ink edit and stamp, but I'm wondering if they will end up in the patients' cybercharts under a heading that will make sense to me. Something that I could just date and sign my initials, now involves at least 5 or 6 steps to complete so that the task is done. All the running around that use to take place throughout the office, is done within the EMR as long as my fingers do the walking, i.e. the right walking.
By mid afternoon, I find that I am experiencing brain fatigue. My eyes also start to become defensive with the screen. I find myself blinking several times, to ease the dry irritation and blurring that I get. It's actually more comfortable to take a break from the laptop, and instead work with my desktop. I've been a bit concerned when I still get messages from my computer that I need to have a back up designated as well as virus protection, but I'm reassured that all is truly well with the folks from EMR land and there is no need to worry. . .
EMR is here to stay, a wanted entity, yet a present foe to challenge me in my midlife years. I have discovered to meet that confrontation I must change my perspective from one of fear and defense to one of strength and offense. After all, EMR is nothing really more than just an exercise for my mental rebirth . . .
It is, I still believe, but what a learning curve to climb! It's amazing the technical advances that are at our fingertips, that all our medical history can now be kept in cyberspace. I am beginning to adjust to listening and typing my patients' present needs. It feels somewhat awkward as I want to still maintain my attentiveness to them despite the square box that sits between us. I realized yesterday that I must learn to think like it does. After all, it's really just an exercise in repeating the same commands. Of course, the challenge is to recall or remember the path to take that will give me the result I'm wanting. And it's consistent to the point of being unforgiving, you cannot stray from how it wants to take your information in.
The biggest issue is coding visits. I love our health care system in the good ol' USA. Every diagnosis has a number assigned which is attached to how much insurance or Medicare will pay. There really is no common sense to what the diagnosis is really called or what category it could possibly be found under. Diagnoses that have always seemed quite straight forward now have other possibilities that you must seek and find. Of course, if you don't have a number to insert, you find yourself trying to find it with a word or two. And don't forget to code for all the procedures you do or the shots you give, plus there's codes for all your history and your family's history too! We love numbers in our world, we have one to identify that we truly do exist and all our medical history now can be reduced to just a numbers game too. I guess numbers in means dollars out, but remember the dollars never come back into your pocket. No, it really is just a way for the insurance companies to ration health care and justify their existence, all the while insuring that their pockets stay lined with gold. . .
The nice feature of e-prescribing stops the busy task of handwriting prescriptions that at times end up lost and have to be redone. Yet, even that involves a series of steps that for now seem easier and quicker to go ahead and write out the prescription. It's the same thing with signing off lab and chart reports, all of that builds up in my "jellybean" of tasks, with daunting numbers---my present highest 24. Those reports use to be just stuck in a drawer that I would get to as I worked throughout my day, but now I see them ever before me and growing. Yes, I'm learning to sign them off with my ink edit and stamp, but I'm wondering if they will end up in the patients' cybercharts under a heading that will make sense to me. Something that I could just date and sign my initials, now involves at least 5 or 6 steps to complete so that the task is done. All the running around that use to take place throughout the office, is done within the EMR as long as my fingers do the walking, i.e. the right walking.
By mid afternoon, I find that I am experiencing brain fatigue. My eyes also start to become defensive with the screen. I find myself blinking several times, to ease the dry irritation and blurring that I get. It's actually more comfortable to take a break from the laptop, and instead work with my desktop. I've been a bit concerned when I still get messages from my computer that I need to have a back up designated as well as virus protection, but I'm reassured that all is truly well with the folks from EMR land and there is no need to worry. . .
EMR is here to stay, a wanted entity, yet a present foe to challenge me in my midlife years. I have discovered to meet that confrontation I must change my perspective from one of fear and defense to one of strength and offense. After all, EMR is nothing really more than just an exercise for my mental rebirth . . .
Comments
Post a Comment