Posted on 06/10/2017 12:36:42 PM PDT by Lorianne
Edited on 06/10/2017 12:59:59 PM PDT by Jim Robinson. [history]
I beg to differ about electronic medical records.
I am a retired clinical pharmacist. In the “Old Days” we had to go through charts and retrieve total medical history charts from the file room to look at a patients history. In reality it was impossible to look at a patients history in detail. There were not enough hours in the day to do it properly.
With electronic records I can swiftly go through a chart. When things pop up that are important I could then go into detail relative to blood work, past problems, organ function, allergies, drug interactions, past disease states, medical treatment that was successful or not, etc. I had all the detail available at my fingertips to ensure the best treatment for our patient. In 15 or 20 minutes I could find out what would have taken me hours using a paper system and depending on the paper records I might have missed something important.
Electronic records are great. They save lives. I have saved lives because of the ability to bring up all this information in seconds.
A doctor can put in an order for a certain therapy. I know of this order in seconds. I can evaluate it for rational therapy. If it is good therapy we finish the order and the therapy is given. If it is not a rational order we intervene. The vast majority of the time the doctors orders are rational and good. On rare occasions they are bad orders. It is our job to stop those and offer alternative therapy to the doctor.
In the past the docs resented our intrusions relative to their drug therapy orders. Today it is a different game. Medicine has become so complex relative to drug therapy they now welcome we pharmacists as part of the medical team.
Before I retired I worked the graveyard shift. On graveyard it is the residents in charge. Many many times they would call and ask for advice on drug therapy. Most of the time I knew the answer but if I did not I would tell them, “give me ten minutes and I will have the answer.” I had an incredible source of information at my fingertips relative to drug therapy. Actually the docs had the same access but were busy as hell. I would find the information and give it to them. WE WERE A TEAM! This could not have been done without electronic records and medical resources available via computer.
I well remember discussions with other pharmacists and docs about the days we did not have this wonderful tool. I said, “I wonder how many patients were harmed or died before we had this tool.” There was silence. We all knew.
Electronic Records save lives!!!!!!!!!!!
The American Journal of Emergency Medicine published a study finding that emergency room physicians are now spending 43 percent of their time on data entry and only 28 percent on direct patient care.
My own personal doctor has complained about the time it takes to keep the records up to date. Even worse, he wonders about the value of 'up to date records.'
The goal of any medical facility in the US, never mind the world, being able to instantly pull up your medical records is a joke. And, based on what I hear and read, it will remain a joke well into the future.
Please see my post #41.
I was VA and just for the record a hard right wing conservative.
Yes, it is a Royal Pain in the Ass to enter all the information. We pharmacists had to do the same. However, the ability to recover a total medical picture of the patient is invaluable. It does save lives.
Where it saves lives is when we do not understand what is really going on with the patient. With electronic records we stand a much greater chance of figuring out what is wrong.
You make a good point.
Sending prescriptions to pharmacies has become easier.
But if they can send all this info electronically to the pharmacist (who can easily discern what the patient’s problem probably is) why can’t they do the same thing between doctors?
I also must praise the Walgreens pharmacist I go to. The whole team there are top notch and sharp as can be. They are ON IT.
And you’re right, they have alerted me to possible problems with drug interactions and dosages. I couldn’t do without them. And they have gone above and beyond the call when there have been problems. The head pharmacist has also been very emotionally supportive and encouraging when I have been down about some of the things going on with my mother. I can’t say enough good things about him and his whole team.
My Doc hates it. And quite a few of the older, more experieced nurse in his office quit.
That’s why the pharmacists are so necessary these days. THEY are supposed to worry about the interactions when the doc prescribes for various unrelated ailments. But in my SO’s case, he’d had a specific requirement for a drug & was on it for the required time. But after that they still kept it on his list of current drugs. Absolutely absurd.
I've had people hand me their prescription "list" and as you read them over, "oh, I only take a half a pill of that" or "the doc told me to take two of those twice a week now". or "that was upsetting my stomach so I don't take it only when I need it".......
ONE little discrepancy in YOUR printed out material could lead to major mistakes/lawsuits...
the lawyers have to make their money...
also, not every single hospital/lab/drs office is on the same software...
in my area, we have competing software where one major group is on one system, while the other group is on entirely different system....and they do not communicate easily...
wasn't somebody complaining that the drs don't spend enough time with the patient and instead do too much on the computer...
maybe you would be happy if the doc never came to see you and just read the notes....
drs and medical and health people do the best they can to quickly get info and there is going to be redundancy....
The pt gets asked the same question to spark the memory, often Dr and Nurse get vastly different histories.
Oh yeah I have crushing chest pain when I walk, but I came here about my bunion.
My experience of 25 years without it and 5 with and counting is painful.
I often break into singing that Barbara Streisand song and sobbing uncontrollably “The Way We Were”.
Technology is NEVER a substitute for good management...........
I like the electronic records. I can go on line rather then dredge through pages and pages.
The HITECH Act has been a complete nightmare.
A guy who owns a software company told me that with this act , the government created captive buyers. The people selling the products only had to put minimal amount into R + D because their buyers had no choice.
I’ve been told that the group who lobbied for it were the data mining groups.
A study came out awhile back that said doctors used to spend 5% of their time on paper work, now 35%. Government makes medical care less efficient and expects prices to go down.
Hospital employees are not even taught how to use paper as an emergency backup!!!
Maximum FUBAR!
If you or loved one ever ends up in an ICU or CCU demand a print out the patient’s current meds every morning.
Most of the different systems can’t connect with another.
Doc’s in the same system have access to the records but instead of spending all their time wandering through pages and pages on the computer, it’s easier and more efficient just to ask you.
I find that the pharmacy is the central coordinating entity in medical care, though I doubt that is officially their job. I practice that’s how it works out.
Wife’s orthopedist refuses to go digital - every time she gets some sort of imaging he requests films and not discs with the results and keeps his office records by hand - “they fine me two percent for not going digital but Medicare doesn’t pay anything anyway, so two percent of nothing is nothing” he says - he’s in his early sixties and intends to retire as soon as he can because of how much intrusion there is in the field by the insurance companies and government.....
Exactly. Since my doctor's practice installed electronic medical records over six years ago, I haven't been back.
I am on Medicare and do not have a choice of doctors else I would not go to a Moslem. That said, I take care of the crotchets of old age myself with diet and supplements and exercise. I go to the doctor once a year for the insurance required checkup to keep the Supplemental insurance in force. Doc gets ALL the blood tests each time and I have learned how to read the numbers. He gives me a copy. He doesn’t care that I do my own. He collects his fees for the checkup which is why I get all the blood tests he can add in short of ones needing special orders. When I broke an ankle last month I went to the walk in. I pay for their charge myself and and lace up my foot in an oversize army boot for a splint and use a cane. I haven’t missed a day of work.
sometimes an assistant goes over some of the answers, but this doesn't seem to help the doc much, since he asks us to repeat all the relevant answers.
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