EMR

The answer to all that is wrong with medicine, the EMR. The electronic medical record will eliminate all medical errors. It will allow safer and more coordinated health care. It will make the patient health care history more secure and yet be available to another physician treating the patient. Sounds too good to be true? That's because it's a pipe dream (crack pipe).

I became familiar with the EMR three years ago. I diligently went to the classes (held of course during the day). The world's oldest ER doc is not a luddite. I may not be the first one to buy the latest technology but I am far from the last. This blog is produced on a laptop using Windows 7. I have a home wifi. I use a PDA loaded with the latest and greatest medical software. My cell phone is 3G and I text with my family and friends. My typing is done with my trusty index fingers, but at 30 words a minute. Ready, willing and able; bring on the EMR.

First let's look at the benefits of the EMR to the ER staff. Having the ability to access all prior medical information on the patient you are treating does improve care. Knowledge is power. Medications, allergies, prior surgeries, radiology reports, and consultation notes give invaluable help to the diligent ER doc. Ordering tests and reviewing the results, and placing data directly into the patient ER record makes for a more complete chart.

The problems arise because there is no standard for an EMR. Each hospital and sometimes individual departments within a hospital choose there software vender and EMR format. Having to maintain the confidentiality of the patients' medical record precludes a health care provider from outside your system from accessing an EMR. Murphy's law applies to both the hardware and software of your EMR system.

Computer systems must be maintained and periodically upgraded. During this "downtime" the overworked ER doc must revert back to "paper". The ability to read the prior records of your patient is lost during downtime. Coders, the people who decipher the doctors gibberish into a form that allows for billing, sent messages to the doc seeking the misplaced paper record. These scheduled interruptions are always on the night shift. I have several theories as to why the B.O.N.E.R. docs and their coworkers are the sacrificial lambs to the computer gods but I will only share my paranoid theories with my wife.

What prompted tonight's blog was a recent unscheduled downtime. Every computer work station in the ER threw us out of the EMR system. A call to the computer help desk wasn't helpful. When one station would freeze, his advise was always the same, "reboot". Realizing that the entire system was out, he boldly proclaimed, "I'll call my supervisor". The higher ranking computer nerds arrived and told us what we had already deduced. The servers for our system are in another state and these servers had "corrupted software". My faithful PA and I softly wept as we confronted this unscheduled downtime. Three hours later the problem was fixed and a cheer and prayer of gratitude was offered to the geek god.

The EMR is a reality. Embrace the new. Drink the kool-aid. Be the nerd.