Thursday, February 23, 2006

Paper & Personality

It's been a busy week. We are in the midst of "Going Live" with an electronic medical records system for our clinics here in Seattle. Between now and Mid-April we'll be turning the system on, one week at a time, over each of eight sites. After months of prep work, and training of "Superusers," I hope it all goes smoothly. (fingers crossed!)

Though I'm looking forward to going electronic, part of me is going to miss the old paper chart, with it's handwritten med list and problem list and progress notes, its little sticky-note reminders stuck here and there and all over, the stapled medical coupon or insurance card copy, the colored dividers for labs and consults and outside records, the creased and torn spine, how after a while when it got too full of stuff it would just fall apart in your hands. I really will miss it. The paper chart had a personality. If a patient called the nurse with a question, and I wasn't exactly sure who they were, one look at the paper chart, and bingo, I could picture the exact patient in my mind. I am just not sure that will be the case with an electronic chart. They are all going to look the same. Alas.

Anyway. I've been on call all week, and it has been fairly steady. Lot's of newborns, as usual. Seven so far. Three by C-section. I miss doing OB, but not enough to start doing it again. Besides, the midwives to a great job, and I still get to attend on all the babies. And it's the funnest part of being on call: examining the newborns, talking with the new parents, sending them off happy.

Clinic has been busy as well. Wednesday starting off with my least favorite kind of visit to see on my schedule: "New Patient. Wants Pain Meds." Sometimes it's a legitimate problem. But too often it is someone merely seeking drugs. And it is often not a pleasant encounter, especially since I usually say NO.

11 comments:

Emily Lloyd said...

Ah, Peter, even as a patient I will miss the paper charts; they do have personalities.

This process reminds me of a young woman yelling into a cell phone just outside the doors of my (where I work) library the other day (everyone in the front of the library could hear her): "I HAVE TO GO INTO THE LIBRARY NOW! GOD I FUCKING HATE LOOKING UP BOOKS ON A COMPUTER! WHY COULDN'T THEY JUST KEEP THE CARD CATALOG??? I HATE FUCKING COMPUTERS!!!" Then she dropped her voice to a whisper and said, "Okay, I have to be quiet now, I'm going into the library." [grin]

Peter said...

Emily: HAHAHA. That is a great story.

I am going to miss the old paper charts. But not the handwriting of everything. If only there were a way to personalize each one.

We do have the ability to place a photo of the patient in one field. Some clinics may scan in the driver's license. Something more interesting would be better, I think. Such as a favorite picture on vacation, or with family, or with spouse. or something like our blogger profile pics, with a hint of silliness.

Pamela said...

I thought I'd miss the paper charts, too, when our hospital went EMR--except that we have even more paper now, and half-paper/half-electronic charts are definitely not any better organized. We've ended up having to print, especially since the nurses have a real resistance to taking off electronic orders. Wait and see, Peter--you'll never escape the post-it notes and the flags entirely--our systems both have electronic ones! I have lived through this electronic charting in two separate facilities. If I can offer any tips, let me know. This is one of my few areas of expertise.

PS My word verification is wrtrblkk==writer's block?

Peter said...

Pamela: It's nice to know you have expertise here. I may have to back channel you with questions.

THE SCRIBE said...

Very Impressive Peter...Just stopping by to say hello to a fellow writer. Check out my blog when you get a chance, you might find something you like....

Anne said...

Emily, that cracked me up. (And at least your patrons know libraries are supposed to be quiet! Mine don't seem to have figured that one out.)

Peter, this post made me grin a bit, because I was at the vet this morning with one of the cats & was noticing "my" charts there. They use one folder for all of the pets in the family, and since I had two cats who lived to be 18 & had ongoing medical problems in their later years, it is one fat, falling-apart folder. The desk attendants pull the folder and immediately know that "oh, we know THIS person." (I would, incidentally, give anything for a doctor as good as my vet!)

David said...

I once was that patient: "Wants Pain Meds." I didn't get them.

32poems said...

You mentioned "superusers." Are you all using a Linux OS for your office's medical records?

Peter said...

Hi Deborah: The "superusers" are staff who received additional training, so that they could help train and support others. Sort of a Train-the-trainer model.

The program a Microsoft-based (?) product called NextGen.

32poems said...

Oh, okay. On another note, this post of your inspired my recent post about my birthing time. If you're at awp, swing by our table. we want to get everyone drunk -- as drunk as possible.

Peter said...

Hi Deborah: Yes I'll definitely stop by! ~grin~