Stupid mistakes are nothing new. But they've really increased in the world of EHR. It's funny... But at the same time it's not.
Thursday, August 20, 2020
Seen in a chart
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A Blog detailing the insanity of my medical practice and the stupidity of everyday life.
Welcome to my whining!
This blog is entirely for entertainment purposes. All posts about patients, or my everyday life, or anything else may be fictional, or be my experience, or were submitted by a reader, or any combination of the above. Factual statements may or may not be accurate. I could be making all this up. I may not even be a doctor. The only true statement on here is that I probably drink more Diet Coke than you do. A lot more.
Singing Foo!
Singing Foo!
Twitter fans- you can follow me @docgrumpy
Cast of Characters:
Annie: My Phenomenal MA
Mary: My Awesome Secretary
Ed: The office fish
Dr. Pissy: The guy I share an office with
Mrs. Grumpy: My Boss (also the world's greatest school nurse)
Frank, Craig, and Marie: The Grumpy Tribe
Garlic and Riley: The Grumpy Dogs
Questions? Comments? Biting sarcasm? Write to: pagingdrgrumpy [at] gmail [dot] com
Note: I do not answer medical questions. If you are having a medical issue, see your own doctor. For all you know I'm really a Mongolian yak herder and have no medical training at all except in issues regarding the care and feeding of Mongolian yaks.
Cast of Characters:
Annie: My Phenomenal MA
Mary: My Awesome Secretary
Ed: The office fish
Dr. Pissy: The guy I share an office with
Mrs. Grumpy: My Boss (also the world's greatest school nurse)
Frank, Craig, and Marie: The Grumpy Tribe
Garlic and Riley: The Grumpy Dogs
Questions? Comments? Biting sarcasm? Write to: pagingdrgrumpy [at] gmail [dot] com
Note: I do not answer medical questions. If you are having a medical issue, see your own doctor. For all you know I'm really a Mongolian yak herder and have no medical training at all except in issues regarding the care and feeding of Mongolian yaks.
13 comments:
Weirdly I could see that being truthful if he smokes, like, two cigarettes a week or some absurdly low amount. I've seen that sort of thing with drinking. Do you drink? Yes. How much do you drink? 0 drinks a week, because I only have a drink once a month on average.
Patient doesn't actually smoke, but wants nurse to think he's cool.
Patient doesn't want them to ignore the possibility of lung cancer.
What Decius said. I used to know someone who smoked 2 cigarettes a day. I used to have a glass of wine about every 2-3 months. I never knew how to answer survey questions about drinking because they didn't have a space for my answer.
The EHR is the meeting point of two bad things: insurance & medicare payments based on completeness of documentation, and user interfaces that enable the use of copy/paste, default inputs, and auto-fill to make lengthy but incorrect statements. When all that's rewarded is points towards a high-level E&M code, all that's produced is gibberish.
What is the threshold for accepting these auto-generated 'bloopers', and not spending time or tire (not enough time) to clarify them in the extemporaneous Notes section?
"patient" was more than 2 cigarettes/week. (2/20)/7 = 0.014
Is that EHRese for "used to smoke, doesn't smoke any more"?
@Decius: Yup, my wife is in that position. She's prone to having a drink on the plane when we fly back to visit her family (transpacific flight) but virtually never otherwise. I would say she averages 2 drinks/year.
These entries are disconcerting for medical professionals, how do you think the patient would feel if they’ve learned the errors are as common place as they seem to be. I arrive at the ER With what appears to be a classic atrial fibrillation. Bloodwork is done, and intravenous dose of some Guap is administered, I spend the night in the hospital to be observed and I’m sometime because I’m back in normal rhythm. I do a follow up with the cardiologist a week later, and the young physicians assistant casually mentions to me that my bloodwork indicated I was severely deficient in potassium. The cardiologist arrives does a complete shift on all my medications and I’m sent out the door I have to follow up with appointments at six month intervals, in the second appointment the doctor tells me I’m experiencing atrial fibrillation, orders no blood test and again mixes up my medications. I go home and say to my wife I wonder if I’m short of potassium I wonder if that’s my real problem nobody has ever checked I’ve had no blood work up since the emergency room visit. Medical practitioners are probably lucky they don’t get punched out more often than they do because they’re just plain sloppy. Finding a good doctor anymore is very difficult. Nobody treats the whole patient. And everybody puts a little note in a chart that nobody ever sees. And the only ones who ever mentioned anything are the physicians assistants
I'm a retired medical transcriptionist, and the garbage I've seen coming out of EHR is almost scary. Back when I was doing medical transcription, if a statement like the patient being a smoker and smoking 0 cigarettes per day came up, I'd flag it. I saw all kinds of odd things, like a patient named Christine with a prostate exam (the doctor got the name wrong), a patient named Robert with endometriosis (turned out Robert was a woman and that was actually her name) and so on. However, since we professional MTs have been removed from the process under the guise of saving money, a myriad of mistakes have crept into medical records that have likely killed people. I keep a very close eye on my medical records, and I ask a lot of questions. If a doctor doesn't like me asking a lot of questions, I find a new doctor.
@vegakitty: I've gotten an imaging result that showed me as female but listed benign prostate enlargement as an incidental finding. I'm not trans, I'm the victim of a name that used to have both male (Loren) and female (Lauren) forms.
@Loren Pechtel: I'm waiting for the first time I'm asked if there's any possibility I could be pregnant. While my name is unmistakably female, I'm 61 and status post a total hysterectomy including removal of tubes and ovaries. So far it hasn't happened, but if it ever does I don't think I'll be surprised.
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