Computers, Patients, Me, OH MY!
So today was the first day we had computerized charting in the clinic. Didn't like it. Not one bit.
First off, we've got some logistical issues to work out, which, when ironed out, should improve the situation a little. For example, we can't have a copy of the patient's chart open in the patient's room if we try to pull up a copy in the attending physician's room, where the case is being discussed. Which means that we're still printing out a copy of the chart, like we used to, and the attending still scribbles his notes on there. Like old times. Except now, someone has to enter in said scribbles back into the computerized chart, or else they never existed. And the same amount of paper is wasted.
Secondly, not having a piece of paper to jot notes on is frustrating. Frustrating because talking to the patient is a conversation, and when a patient rambles about something, it's nice to let them finish their thought before asking for clarification about a pertinent point. Which used to be easy - jot a note or mark the thing that needed more clarification. Frustrating because it used to be extremely efficient to write down the pertinent history right away, and now I have to either type as someone is trying to tell me all about their health problems or try to remember it all and spend extra time after the patient is gone trying to enter this information into this electronic chart.
Lastly, and most importantly, I have to somehow use a computer while someone is trying to tell me about all their pains and still try to convey that I care about them and their problem. Extremely tricky. The first patients of the day were subjected to this painful process. At the end of the day, the last patient had seated herself on the examining table, not the chair, which happened to be 180 degrees from the computer. So rather than swivel like an idiot, or ask her to please move to the chair so I could see and type, (what a silly request!), I gave up and reverted back to writing on a piece of scrap paper, which was used after the patient left to enter data into the electronic system. Behold, my friends, a case of wasted paper and extreme inefficiency, and a prime example of how technology solves and CREATES problems.
First off, we've got some logistical issues to work out, which, when ironed out, should improve the situation a little. For example, we can't have a copy of the patient's chart open in the patient's room if we try to pull up a copy in the attending physician's room, where the case is being discussed. Which means that we're still printing out a copy of the chart, like we used to, and the attending still scribbles his notes on there. Like old times. Except now, someone has to enter in said scribbles back into the computerized chart, or else they never existed. And the same amount of paper is wasted.
Secondly, not having a piece of paper to jot notes on is frustrating. Frustrating because talking to the patient is a conversation, and when a patient rambles about something, it's nice to let them finish their thought before asking for clarification about a pertinent point. Which used to be easy - jot a note or mark the thing that needed more clarification. Frustrating because it used to be extremely efficient to write down the pertinent history right away, and now I have to either type as someone is trying to tell me all about their health problems or try to remember it all and spend extra time after the patient is gone trying to enter this information into this electronic chart.
Lastly, and most importantly, I have to somehow use a computer while someone is trying to tell me about all their pains and still try to convey that I care about them and their problem. Extremely tricky. The first patients of the day were subjected to this painful process. At the end of the day, the last patient had seated herself on the examining table, not the chair, which happened to be 180 degrees from the computer. So rather than swivel like an idiot, or ask her to please move to the chair so I could see and type, (what a silly request!), I gave up and reverted back to writing on a piece of scrap paper, which was used after the patient left to enter data into the electronic system. Behold, my friends, a case of wasted paper and extreme inefficiency, and a prime example of how technology solves and CREATES problems.
posted by Aisling at 6:59 PM PERMALINK
4 Comments:
I find the computer doctor thing eerie as well. What a better way to make a patient feel yet again like just another number...
On the other hand, as a patient of a doctor who uses computerized charting and uses it to his advantage, I have to say that when you get it working, it's fantastic.
My doc uses some kind of electronic tablet that is a screen but you write on it with a stylus. At my last visit, he tapped the screen in one place and out of the printer came a renewal for my prescription. Then we discussed some pain I'd been having in my shoulder, and instead of searching through shelves of papers, he just printed off a handout on exercises I could do to help it out. I was really impressed.
On the other hand, I can see how, if you're having to do it at a sit-down computer with a keyboard, it would be really awkward and no fun at all.
What's impressive is how the system is connected to other things (patient education forms, prescription forms, etc.) Tablets are good because they are just like pen and paper - I can sit and face you while you talk and jot notes on the tablet, instead of listening, then turning to face the computer monitor why you continue talking...
Here is a heads up on something that could happen: I called my doctor after realizing that I had forgotten to tell him I was breastfeeding and that much of what he'd prescribed for me wouldn't work. I felt very stupid, because I'd reminded myself again and again to tell him. I told the nurse, I'd told him at a previous visit but I knew he wouldn't remember a detail like that. This was the first time I'd been treated by a doctor who hadn't delivered my babies.
I called an hour after the appointment. This was, apparently, entered into a message on the computer system that he would access at his convenience. I waited until the next afternoon and called again. He hadn't responded. It took three days. One of the prescriptions was an antibiotic that he hadn't told me was actually preventative (sinus and ear troubles) so then I realized he hadn't respected that I would be intellegent enough to understand that bit, either, and I thought I was still being treated for an infection.
I won't be going back.
I think part of the problem was that the communication lost all humanity and urgency when it lost the face to face. Make sure that doesn't happen.
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