Monday, August 31, 2009

Doctors: The Electronic Log Jam

With the increasing push for medical records to go electronic, I continue to be amazed at the ability and speed that information gets pushed my way.

I have already mentioned the multiple servers that we must interact with daily, and today learned that soon our pacemaker checks will soon become "paperless," permitting me the ability to log on to yet another server so I can sign my pacemaker checks electronically! Whooo Hooo!

Not that this is bad, mind you. I think it's great that all of this information will eventually be added on-line for all to see. There is no doubt that communication will be improved.

But despite the gleeful enthusiasm of the information technology gurus, I find that I am increasingly becoming the log jam that prevents the information from flowing to the electronic medical record. As more and more results and reports require the electronic signature, it is becoming increasingly difficult for some of us who do not spend the day at the computer screen to promptly sign our results and move them to the chart. The IT specialists and administrators realize that someone has to take the fall if there is a problem amongst all those results, so all of them pass before the doctor. But few of these technology people realize how long it takes to scroll down to find the results of a test that appears below a tiny pop-up window or the time it takes to decompress a pdf file on each test result reported. Multiply those times by hundreds of results or reports a day and it's no wonder doctors remain skepical of a computer's ability to save us time. The more tests and electronic signature requirements must pass beneath my typing fingers, there is a limit as to how fast it can find its way to the patient's chart.

Of course the IT specialists are all to happy to point out that you can highlight all of the results at once and click "Sign-'Em-All" and, presto, they're on the chart. But doesn't that defeat the purpose of checking and reviewing the results? Sadly, I fear that human nature will do just that as doctors look for ways to relieve the log jam that appears in their result inbasket each day.

But then again, since the computer will get its "signature" with the click of a button, we'll have 100% compliance with reviewing all our test results results, won't we?

-Wes

1 comment:

Dr. Brenner said...

This is so true. When docs have hundreds of charts/results to sign off on, every extra click and wait time for the computer to load the results, is wasted time for the doc. And multiply that out, is definitely significant. there is the temptation to just sign off without looking, but then you increase liability risk amongst a zillion other things.

I wrote a blog about some of the pitfalls of IT in medicine: http://drbrenner.blogspot.com/2009/06/drowning-in-paperwork.html

You have definitely added to my discussion. I'm not against IT by any means. But it is not as easy, as quick, and as efficient as people think. And while some errors decrease, new ones emerge.

Thank you for your blog.