Tuesday, June 30, 2009

Virtual Consultations

"I'll be damned."

They were the first words I heard after I was called to the Emergency Room to see this older woman in complete heart block with a wide-complex escape rhythm at 33 beats per minute.

"Could this be why I've been so exhausted any time I try to do anything?"

Her disbelief continued.

I turned to the medical record to document my findings, notify the personnel to stick around for another pacemaker, only to find that another cardiologist had been notified of the patient's admission, written a note, and made an assessment - all electronically.

No detailed history. No exam. No review of labs.

Just this praphrased note on the chart from a doctor at another facility:
"3 weeks of fatigue. EKG demonstrates complete heart block. Pacer to be placed in AM by Doctor Frigamafratz."
A virtual consultation from another hospital, courtesy of the Electronic Medical Record.

"I'll be damned," I echoed.


1 comment:

geena said...

This is worse than the docs who come into my ICU, grab a chart, sit at a computer and transcribe labs and nursing assessments onto a progress note without ever laying eyes on the patient.

But only by a little. At least these docs are in the same vicinity!