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    "When many cures are offered for a disease, it means the disease is not curable" -Anton Chekhov

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    Monday, November 07, 2005

    Bursting Bubbles: Here's another reason to curb the enthusiasm over electronic medical records. They don't necessarily increase efficiency. In this study, doctors actually spent more time documenting and writing orders when they moved to a computerized system:

    Using bedside or point-of-care systems increased documentation time of physicians by 17.5%. In comparison, the use of central station desktops for computerized provider order entry (CPOE) was found to be inefficient, increasing the work time from 98.1% to 328.6% of physician's time per working shift (weighted average of CPOE-oriented studies, 238.4%).

    The efficiency depends on the doctor and the system. Having to move from the patient's bedside to the nursing station to enter orders and notes is extremely inefficient. It breaks the chain of thought, creates a back-up at the shared computer, and requires more time to go from room to station to room to station again and again.

    I've found that my electronic record hasn't saved me any time. It's faster for writing my notes and answering phone messages, but it's slower when it comes to letting me review and respond to labs and test results. It's hard to get any quicker than the old paper system. The labs, x-ray results, and daily letters from consultants would arrive on my desk in a folder. I would glance through them, sign off on all the normals, and put aside all the abnormals to have their charts pulled. It meant more time for my staff in pulling the charts, but I could do my part in a matter of minutes. Now, the staff scans the results into the patient record as they arrive. It takes longer to click and open the lab in the computer's "To Do List," read it, and sign off on it, than it does to eyeball a piece of paper and scribble my initials on it. It also takes longer to go through the various screens to review prior labs and notes when a result is abnormal than it did with the paper chart.

    In the long-run, it's a trade-off I find acceptable. I probably end up spending the same amount of time with paperwork (although now it's pixel work), but the computerized system does have the added advantage of getting the information filed in the charts in a timely fashion. (With the paper method, those normal labs and letters would sit in a "to be filed" pile for weeks until I nagged the staff to file them.)

    (via Medical Computing Review.)

    posted by Sydney on 11/07/2005 08:21:00 AM 0 comments


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