Stranger

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Jane from Out of the Rabbit Hole on my It’s All An Act… post last week asked if I could change one thing in the medical field, what would that be? 

No question about it. 

It would be my EHR (electronic health record).

I have spent 8 years in a hell of sorts because of that damn thing. All day long it is a constant onslaught of little annoyances and big annoyances and it never, ever stops. 

It only gets worse.

I tried to get on the EHR committee, but my arch-nemesis is the gate keeper. No go. I even applied for jobs with the company that makes this god-forsaken EHR, to no avail. I looked for another job practicing elsewhere, thinking that a new EHR would be better, but they all sucked just as bad.

Through a strange twist of fate I found out yesterday that we will be getting a new EHR in the next 16 months. THE best one on the market. 

Finally.

After daily suffering day in and day out, grappling with the anger and frustration and not knowing what else I could do about it….

Poof! Gone.

I have spent so much time and energy being angry about it that now I feel… 

LOST.

(This is day #4 of the Black and White Challenge. Yes, that is a huge, life sized dinosaur. I was running as I snapped it. Today I am nominating Dragonflyzia!)

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60 thoughts on “Stranger

  1. Understandable. And isn’t a perfect illustration that all our anger and frustration don’t have any effect on the outcome? I’m glad you’re getting the new and improved EHR and I hope it truly IS better than what you’ve had to deal with in the past.

    Liked by 1 person

  2. Administration systems are the burden of civilisation.

    May you find a dinosaur to trample on them or to carry you over them. A pterodactylus would be nice.

    Liked by 1 person

  3. I recognize that dinosaur! https://www.youtube.com/watch?v=gF9fkfNjc2g S/He gets around – there can’t be many like him/her in the Actor’s Guild. Ha!

    Congratulations on your new upcoming EHR. Hopefully the new and old systems are compatible so the data can be transferred and you don’t have t work with both. Our city gov’t here in Ottawa acquired a new system last year and were unable to transfer records – so they now run two systems , all new material going into the new system. You would think they would check such a detail before buying.

    Have no fear Victo – you will find a new cause – may the old cause rest in peace.

    Liked by 1 person

  4. Congratulations. The new EHR is bound to be better.

    It seems to be the way the world works that when you get intensely focused on something and the something goes away, there is a vacuum. Hey. Maybe they’ll form a new EHR committee and your arch-nemesis will go away, too.

    Liked by 1 person

  5. Yahooo for youuuuu .. EPIC… we may get pushed up to get on it sooner. Mothership is on it so we must, but they said 2018. Maybe sooner. We can struggle together to learn it. We actually are learning a piece of with E-Record. If we are going to be homecare of choice for the Mother, we need to all be on one EHR.
    ah, here is a new request for another blog post. Tell us about your Nemesis. I think we all have one. Mine is a doozie.(I have another name for her)

    Liked by 1 person

  6. I know what EHR is now because of my new job, I create tasks everyday using it. It doesn’t bother me because I am still in the gratitude and newness faze of my new job. πŸ™‚ I see that you nominated me for something….what do I do? and thank you.

    Liked by 1 person

    • Never! It was very hard going from the amazing EHR system to paper for three years. Then when they finally picked and implemented an EHR, I naively thought they were all great. It wasn’t. Still better than paper but to suffer through that EHR knowing how good it could be? Made it ten thousand times worse.

      Liked by 1 person

  7. As an ex-IT-geek who designed medical systems for a very brief proportion of my career (enrollment/registration, patient/caregiver encounter tracking, medical billing), I am very interested in this topic.

    (1) How does the system–both the software, and the human/political–accomodate patient corrections to the record? I ask because:

    (a) Major Institution’s e-record has had the wrong meds for me–including meds I have never taken–from day 1, and all parties have refused or failed to correct the list. They say “Only a doctor can correct these. Tell a doctor.” On each visit, I am asked to review the med list. I correct it. I tell the doc. No corrections are done. Same list next visit.

    (b) Often, ill-educated lower-level staff take first-line reports of patient complaints. Notes get into e-records such as “She says she has the shits”. Which is what came from me saying I said I had “Behcet’s”, including spelling it out for the woman who took the report. Her version is now part of my permanent medical record.

    I could go on. (And too often, do πŸ™‚

    (2) I don’t understand the division/handshake between the e-record and the medical billing system. It would seem the two would have to be at least nodding acquaintances when it comes to ICD9 and CPT codes, yes? (Since, why rewrite what the codes already indicate–just freehand what they do not–or so I would think.)

    (3) Does the new system catch the fraud of copied notes from prior visits? Or visits labelled “no-show” which have notes and are billed for as a complex visit? You probably know exactly what I mean. Little treasures from one of my rheumatologists here in L.A.

    This may be too much stultifying nerd detail, but I was simply terribly curious.

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    • I am not sure about what you are asking on #3. As for #2, our system currently is piecemeal. There is a program for scheduling. The EHR itself, the lab program, and a billing software. Our billing stuff has to be transcribed into the billing program by hand. It does not communicate with the EHR because the system sucks, so there is plenty of room for error. My suggestion for #1 is to talk to the office manager and let them know how the system is not working for you as a patient. Our patient portal does not really communicate with the EHR. So patients are misled to think that when they change things there that it crosses over. I often leave the PRN meds on the med list. You may not take it all the time but it frequent enough that I do not want to have to rewrite it every single time. Or diflucan. I leave it on the list to remind me that if you are prone to yeast infections that you need a refill when I write an antibiotic. You might ask your physician why he is not changing the list. There may be a reason. Or they might be lazy.

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      • Thank you. Many physicians. All have failed to correct the list. On multiple visits. What I THINK is that each physician is concerned only with the direct information s/he needs for that specific visit’s specific issue.

        Office manager? All is centralized. Why didi I pussyfoot? This is UCLA. I have spoken with the central facility I was directed to and still no change. The “they”s, in my experience, rarely care at all what patients have to say about our medical records. The records are not considered ours, and any contributions or changes we make are discounted in favor of those made by respected contributors: Physicians.

        Sorry, Victo, but that has been my repeated unpleasant experience. It sounds like you have had some unpleasant experiences of your own with the typical inefficient support systems that were not designed to smoothly interface with others–inexcusable poor design, BTW. I’m sorry for you and all the other caregivers and patients who suffer for it. Worse, someone made big bucks from selling these POS systems. Glad you will see improvement soon!

        Liked by 1 person

      • If it is a multi-specialty group you may be having turf wars. It irritates the hell out of me when some specialist removes a patient’s chronic meds without notifying me. There may be an agreement that they will not remove each other’s meds. This is one of the serious problems with shared EHRs.

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      • What I mean by number (3) was that I visited a doctor who created visit notes by copying whole-cloth the visit notes from a prior visit. He billed, if I recall, for a complex visit. I do have copies of these notes, for I sent for medical records from this office. However, if you go through the billings, the office claims I was a no-show for one of the visits at which I showed and they billed my insurance.

        THAT’s the kind of stuff I mean. Any system worth its salt would catch this kind of stuff very easily. For instance, the duplicated notes can be caught by the same simple software used by colleges to catch students using plagiarized essays. The no-show versus billed-out is a no-brainer code/date comparison.

        Liked by 1 person

      • You may be seeing the EHR template. Mine is a bunch of buttons that I have to click for various parts of the exam. The EHR then generates the exam from there. It is virtually identical unless there is something different noted and a different button is clicked. The notes are terribly similar each time. On the one hand, doctors have to skim more through fluff to get to the juicy parts. Very frustrating. On the other hand, you get a standard note that meets documentation requirements for billing purposes.

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      • I may be too critical–I often am–but I suspect you are too generous and would agree if you saw the notes in question–IDENTICAL. This guy, it turned out, had already gotten into trouble previously for MediCare fraud. I think it was a case of the tiger not changing his stripes.

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