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Electronically Speaking

December 20, 2012

In the ongoing debate over electronic medical records (Wait, is there a debate?  Maybe it’s more a conversation),  an example today that illustrates why we doctors hate it.

So I have a patient today that has bad arthritis in his right knee and needs to get it replaced.   For reasons that HIPAA will not let me say, he needs a transfusion of a blood product before surgery.  Miraculously, someone had had the foresight to actually make sure this product was available for him.  Great!  That’s a whole other story line we didn’t have to get into.  So he got the product right?  Well, the order for the product has to go into a physician online order entry system.   OK, so I did that.  The nurses say “you didn’t put it in”.  I say “yes I did”.  They say, “well it’s not coming up.”  Turns out you have to do pre-op orders IN preop holding.  You can’t put them in in a computer, say, upstairs.  Even though it’s supposedly the same system. 

Say I’m a surgical resident.  I have a thousand patients to round on in the morning, but I’m also assisting in a case in the operating room on someone I know needs X pre-operative medication.  I can’t just drop an order in any computer that happens to be nearby.  I have to physically go down to pre-op to order it, then go back up and do whatever else I was doing.  THIS MAKES NO SENSE.  I’ts not better for patients, it’s not better for doctors, it’s not better for nurses, it’s not cheaper, it’s not safer.  It’s just a pain in the butt.

Show me an online medical record system that integrates everything on one screen with one sign-in, that imports information automatically from pharmacy and laboratory systems, that functions in all capacities everywhere I work and does not require redundant data entry and I’m there.  No federal subsidy required.  Until such time, just give me my blood product OK?!

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