Posted on 02/24/2020 3:39:45 AM PST by gattaca
Correspondent Lee Cowan checks in on Epic Systems Corporation, of Verona, Wis., a software company that has changed the way medical records are kept, accessed and disseminated.
I doubt it knowing how complex they are. I’m not saying epic is great, just the best one out there. And it actually does benefit the patient. You would be surprised how many people show up at a hospital not knowing what their medical history is or what medications they take. At least woth the EHR I have a fighting chance to find at least some info.
The physician complaints about Epic are they they track EVERYRTHING—and that stuff is reviewed by managers who do not know how to manage.
I’ve done some work as a consultant and analyst on clinicians and their effectiveness.
What these EMR systems have done is to make it easier to get data. The problem with that is the people working with the data are idiots—and they turn around and say to the docs, “Why did you do that?” “Nationally we can turn around a discharge in 2 hours, how come you added that extra test?” “Why did that bed remain ‘dirty’ for 24 hours after the patient died.”
The “quality management” movement seems to just be entering into the Hospital Administration world. I came into the hospital world after being a Strategic Initiatives guy back in the mid 90’s. I would sit in meetings, literally with my jaw dropping, at how shitty these managers were. And when I started my last “life” in that field I can see how that—combined with almost unlimited access to real time data—is screwing the MDs and nurses.
Epic may seem to be the cause. Its not. It is crappy training, crappy management, and crappy implementation—just as SAS was crappy in the 1990s.
(And never, in 30 years of doing this stuff have I met a more close minded group of people than hospital administrators.)
Good point!
Probably. But it would just be easier to shoot the administrators.
I love my digitized medical records.
I can go to my page and everything is there. Most important are all my lab results with tests too numerous to remember. For many of the tests there are graphs that present the trend.
Ditto all my medications and medication changes.
ditto appointments
ditto medical conditions
I then made an appointment with a doctor in city B. I asked the office if they would like me to have my records sent from the city A hospital. They told me that they had already used Epic to suck them out of the city A hospital computer.
As far as I could recall, I had not yet informed the first hospital which doctor I would be seeing in city B.
To me this seemed to imply that there are ways in which Epic can get around HIPAA. It should be necessary to give permission at the sending office before records can be transferred.
did you have a referral made?
Epic is worse than that. The interface is clumsy, and the processes by which one documents require an over-attention to the computer screen. There is literally 90% focus on charting correctly and 10% on patient care.
What were you on before. We had MediTech, which from a non clinical perspective, looked like 1980’s tech. But I was an operations guy. I found their interfaces with telecom tech to be clumsy.
Bush was almost as bad as Obunghole was. Still could not have voted for gore or Kerry.
I had a referral and a followup procedure done last fall. My doctors office uses Epic. Neither the referral nor the offsite procedure are in my patient record.
Vitals like BP are not recorded in their system.
It sucks
I went to an urgent care clinic for something and had to have a prescription. ..a couple months later I visit my regular doc (not part of any clinic) and he asks why I had this prescription ...no one asked permission. ..I assume as long as both are collecting info on me, they just pass it around.
True, but it's also true that like any database, garbage in, garbage out, and there is a lot of garbage in Epic. There are very often wrong diagnoses entered, and important diagnoses excluded. Plus, when Epic is initiated they don't include much of the patient’s history (generally don't go back more than 3-5 years. Thus the transition itself introduces loss of info.
Also, when you think about all the time you spend ‘clicking boxes’ during an office visit, it is clear that this taking away from time you should be spending face to face with the patient, and/or going through their data.
I do strongly believe that it wouldn't be difficult to make something dramatically better than Epic. I respect what you are saying, and appreciate the upsides of an EMR, but none of them are what they should be at this point.
agree. But the other problem is the EHR takes the blame for clicking boxes when it is the government (CMS) that defines which boxes have to be clicked. I am on our hospitals build team and almost everything we build is for one regulatory agency or another. If we got the govt out of health care that would be the best improvement imaginable
Completely unrelated:
Totally agree. You know it is just a matter of time before travel to China and other coronavirus-related questions are incorporated.
I equate just about anything digital and either directly tied to the internet or can otherwise be remotely accessed as “kool aid”.
America just can’t drink enough of it. Facebook is a prime example of some of the best flavored koolaid that total idiots cannot get enough of it. Digital phone are likely worse than Facebook as just about everyone has one and nothing is secure on them.
The list is not only longer, but increasing in size with each new device that supposedly makes our lives easier and more fun.
Judith Faulkner, CEO and founder of Epic, has a $4.3 billion net worth. She’s working on an “Alexa of medical records..” She says, “the doctor would just say, ‘hey, Epic, show me Lee’s history,’ and that would show up.” And at the end, the doctor would say, ‘hey, Epic, write my note,’ and the whole note would be written.”
Voice recognition in medical records has been around for years, but now Amazon is getting involved.
I was not referred to the doctor I went to see in city B (my local city) by the doctor/hospital I went to see in city A. They only told me the type of doctor I should be seeing.
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