Monday, July 11, 2016

Seen in a chart

Nothing can make a doctor look stupider than an EHR (computerized charting) system.

Smoking is, to me, a good example. We all ask "Do you smoke?" There are 3 basic answers: "Yes," "No," and "I used to."

That isn't so hard. I mean, yeah, occasionally you'll get someone who uses snuff or has some other answer, but in 98% of cases the answer is one of those three. My somewhat primitive human brain can handle them pretty well.

Of course, when you turn this simple question over to an EHR, you get crap like this:

What the HELL does that bizarre combination of phrases mean? In a few lines the patient has gone from being a smoker, to a chain smoker, to a non-smoker, and back to a smoker. And what's an "aggressive non-smoker" anyway? Someone who whips out a fire extinguisher and sprays people who light up?

They tell us these kinds of programs make medicine easier and safer for all involved. I think they're smoking something.


Mari-Ann said...

I have no idea why, but I envisioned Bugs Bunny whipping out a fire extinguisher and spraying Yosemite Sam. I need a vacation. Hope yours was great!

Liz said...

Maybe someone bought a naughty Hungarian to English dictionary.

"I will not buy this tobacconist, it is scratched."

bobbie said...

Gobble-dy gook!

Welcome home!!

Ms. Donna said...

Hope you had good time off.

Like Mari-Ann, I had a fleeting vision of Bugs wielding fire apparatus. ;-)The problem with EHR is, I suspect, that it is written by non-medical people. And the programmers stayed up way, way late and were under orders to capture EVERYTHING, which is why you get this nonsense.

My hope as a pt is that this gets resolved quickly. Please complain EVERY TIME EHR spews nonsense like this. If users don't speak up, this will continue and at some point, someone like me is going to get hurt. Pts don't know about this, so its up to MDs and RNs to yell.

Thanks for the laugh and thought provoking.

Unknown said...

Aggressive non-smoker:

Won't let anyone smoke within 10m of them, their child, their pets, the property line, other peoples' children, other peoples' pets, other animals, etc.
Sprays down smokers with febreze before letting them in the house.
Won't ride in the car of a smoker, states dangers of third-hand smoke.

Smokes when drunk.

Anonymous said...

It sounded good to a lot of politicians and it made some software companies a bundle.

Anonymous said...

I love it when I actually laugh out loud. That's why I visit on a daily basis. Thanks, I needed that. You have a gift.

Anonymous said...

Love it.Deb hit the nail right on its head.

I wish that if a person didn't want to answer a question, the EHR would leave the spot empty, get rid of the question and free up the space.

I have now gotten in the habit of 'saving' my tediously prepared free-form text with Control+C text I use to document what is happening to the patient. It is mind-bendingly annoying to get to the end of a well-thought out description using all the abbreviations I can, only to get to the 'save' portion and have the message flash across the screen that I exceeded the word or space limit and 'whiz shebang' it's all gone. By about the third time, I guess I have come up with the well-rehearsed summary. I guess.

vegakitty said...

I'm a retired medical transcriptionist who lost their job when the client went with EMR. I've read more nonsense in charts due to EMR than I ever heard dictated. At least when there's a living person in the loop, most of the mistakes can (hopefully) be caught and corrected. Those transcriptionists who are now editing EMR are only paid, on average, 3 cents a line, because they're supposedly not having to type the report so they don't "do the work that warrants higher pay" (transcription companies have actually said this) but because most EMR-generated reports are full of mistakes MTs are being paid 3 cents a line to more or less retype the report. I refuse to work for such a piddling amount, so I retired. At least I had that option. MTs who are trying to support families are hurting big time. I'm glad Dr. Grumpy checks his work over before it goes to the chart, but he's a rarity.

migraineur said...

If I see you smoking, I will assume you're on fire and take action accordingly?

KJL said...

EMRs are a complete disaster - we're reduced to data entry clerks. I have to enter all my own orders by code, provide an ICD10 code and make everything fit their boxes. To look at a patient or, even more rarely touch one, eludes the incoming generation of providers. God help us all. I can retire fairly soon but if I NEED health care, I'm on my own.

jbt369 said...

And what's an "aggressive non-smoker" anyway?

Someone who just quit.

Anonymous said...

You should really enter that into a poetry slam.

Anonymous said...

Maybe the patient is a smoker who gets aggressive when he doesn't have a cigarette?

Mage said...

Welcome back.

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