Friday, January 17, 2014

Electronic Triage

Type a note.
Use a shortcut.
Cut and paste.
Order a test.
Review your tests.
Every result gets a note.
Release the result.
Ten new patient messages arrived.
See vacationing colleague’s results.
Did you see your patient’s been scheduled?
Verify you saw your patient was admitted.
Verify your order.
Sign your verbal order.
Telephone message.
E-mail message.
Operative note.
Code the note.
Bill the note.
Type instructions.
Order a procedure.
Print the summary
Update the problem list
Verify the medications – all of them – again
Update the medical history
Update the surgical history –right or left? When?
Family history?
Social history
Immunization history
Verify the allergies.
Make it meaningful.

Now repeat.

This is today’s electronic reality for doctors, and it’s getting worse every day.  Everything, it seems, must pass beneath a doctor's fingertips.

But there’s one thing skill that doctors have mastered when flooded that computer scientists and policy makers haven’t:


And electronic triage is happening every day.

It has to.

After all, this is about life and death for everyone involved.



Anonymous said...


Bottom line, this cyberenslavement that you describe is beyond reprehensible. But I don't envision a catastrophic meltdown or revolt by the mass of obedient doctors. The triage you describe will set the stage for a multitude of new medical-legal liabilities. You once wrote of the top 10 reasons to be a doctor. I would challenge that with the top 100 reasons not to be a doctor. Let's be real. A once proud, and still noble profession has sadly and tragically gone down the crapper. This dystopic social transformation will not end well.

Anonymous said...

Dr. Wes

I would like to read your post but first I have to complete the list of things to do on my patient. If you could reduce your posts to one word then I could probably squeeze in the time to read it.

Peggy Polaneczky, MD said...

I am starting to feel like a hamster on a wheel. The barrage through my in basket has become almost intolerable. I feel like my work has become a series of niggling tasks and not patient care.

This post you've written captures it perfectly.

I can't wait for ICD-10. I think it may be the last straw for many of us.