Friday, October 23, 2015

Department of Redundancy Department

Seen in a chart:



I'd like to start a semi-regular feature of the worst, stupidest, crap seen in EHR (computerized charts). Anyone wishing to contribute please email me de-identified pics or screenshots. Your identity won't be revealed. I think we owe it to others to show what POS's most of these systems really are.

19 comments:

  1. Isn't this idiocy required by the mis-named "Affordable Care Act" (Obamacare)?

    Which also requires that the government gets copies of all your personnel records too?

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  2. That's gotta be one of your 10 best post titles. :D

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  3. https://warmsocks.wordpress.com/2013/12/04/more-problems-with-ehrs/

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  4. ZDoggMD covers all the bases here:

    http://zdoggmd.com/ehr-state-of-mind/

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  5. I repeat myself when under stress.
    I repeat myself when under stress.
    I repeat myself when under stress.
    I repeat myself when under stress.

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  6. And you know that someone is still going to miss seeing that in the chart.

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  7. I admit I am a bit of grammar/spelling police type. But what drives me crazy is when things are misspelled on the charting system....in our nurses notes the word "genitalia" is misspelled and then spelled correctly in several different area. And repetition - the same things to chart, repeated in different areas.

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  8. Help wipe out and abolish redundancy!

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  9. Three different relatives with hypertension?

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  10. We implemented one a year or two back and it was so bad that we are close to choosing the replacement for it. Waste time and money much?

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  11. "Simplify, simplify,simplify!"

    or more accurately (and slightly simplified)
    "Simplify, simplify."
    or "Simplicity, simplicity, simplicity!"
    - Henry David Thoreau

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  12. Don't blame the EMR, Blame the implementation.

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  13. All work and no play makes Jack a dull boy.
    All work and no play makes Jack a dull boy.
    All work and no play makes Jack a dull boy.

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  14. Bad quality has been adopted as the new standard.

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  15. In my job, there are a lot of misspelled words. One obvious fraudulent prescription was brought in for a hold-up with the perpetrator handing the pharmacist a handwritten prescription for 'morfeen'.

    The words that make me cringe as commonly incorrect spelling of the words, separate, elixir, and 'agitation' (as ordered by the consulting neurologist "Valium for aggitation".)

    I don't think I see too many misspellings by prescribers as pharmacists consider themselves experts at reading the illegible as well as telepathic mind-reading, so one might suspect that if an order wasn't spelled correctly, we already 'know' what it's supposed to be, and call the prescriber anyway to verify our suspicions.

    (No I'm not going to 'bite' on the derogatory comment about the ACA when the reason why it took so long for implementation of Electronic Health Records (EHR) was our fellow Americans couldn't agree on a national single payer system for which all documentation, record-keeping, insurance reimbursement would require only one standardized format... instead, we have zillions of incompatible programs for every task of processing health-related data.

    Every single pharmacy where I work has a different computer program for processing medication orders. A few years ago I worked with a pharmacy temp agency and the most user-friendly computer program was at Walmart which had expended a large amount of money developing a program in which any pharmacist could use to find required information to process retail prescriptions. It did not run by itself, so operator error might still be a factor.

    Some of the programs I was expected to figure out at the drop of a hat still had glow-in-the dark minimal pixel letters on a black background. The screen presentation might not be the best indicator of the computer capability but Walmart's program was set up so that a pharmacist could find the relevant information relatively quickly.

    (Interestingly, the current majority of politicians in the great state of Indiana are upset that the Public Health Dept keeps track of required immunizations, as if it is a big question about liberty and individual right --something to get ones' panties in a bunch, as if school nurses should trust parents to tell them thair kids received their measles shots... .)

    (No, I will not get upset about a disparaging remark about the ACA, when 'we' were supposed to have gone 'paperless' 15 years ago and use kg and cm for recording weight and height ever since I was a kid... hmmm, maybe half a century ago.)

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  16. Why is the EMR a POS when it's humans that enter all the info that comes out of them? Just sayin'.....

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  17. The Cynical Pharmacist has countless examples of bad eRxs from MD's offices. Please tell me someone other than the MD enters these in. (In that case, they're forgiven, if an MD, totally inexcusable)

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  18. Sometimes it's the EMR that's the problem; usually it's the person using it. An example of the former: a doc I consulted noticed that her medical assistant had misspelled a rare illness that I've been treated for. She had to email IT and ask them to correct the spelling, because the POS EMR would not allow her to correct it herself. Oy!

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  19. @Anon 8:03 MAs in my office print many of our scripts and I believe this is a common practice but not a great idea.

    I ask them to reprint about 50% of the Rxs due to errors. I correct old ones in the EMR so they will print properly next time but our EMR automatically reverts to the old Rx instructions. The MA must copy and paste updated version, which is sometimes asking too much of them.

    Our MAs have many hours of formal and on-the-job training on the required components of a basic prescriptions. They can always refer to my note for the proper format. Yet the errors and omissions continue.

    Three of our staff members have dyslexia and other learning disorders. This may explain many of the ongoing errors. Or maybe they just hate me.

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So wadda you think?