Today's entry follows upon the heels of the wishful thinking April Fools' Day post. (I do have it on good authority that Apple really IS working on medical software, but my source would have had to kill me had he elaborated.)
The dirty little secret seems to be that the EHR programmers didn't know their software would be used on real, live patients! Wow...
Several developers of widely-used electronic medical record (EMR) software were invited out of their cubicles last week for a much-hyped tour of the real-world health care system.A volunteer team of medical office managers showed the visiting programmers around inpatient hospital wards and outpatient clinics yesterday, carefully coordinating the visits so the programmers could witness physicians in the full swing of patient care. Seeing their products being used in actual clinical settings for the first time, the general response of the developers was shock.“Wait, wait, wait,” said Bingo “Bozz” Murdoch, developer of MediQuickChart Systems. “They’re actually using our software to, like, keep track of real patient records,” he noted. “And they’re trying to enter the data real-time.”Murdoch simply shakes his head when asked about the many levels of inputs and multiple levels of exhaustive drop-down menus. “You just can’t get all of medicine into a dropdown menu,” he said incredulously. “It would just be impossible. That’s why we just picked a handful of interesting diagnoses and codes to include in the system. These systems were never meant to be comprehensive.”EMR software has long been a source of headache and delay for physicians and associated health personnel alike. Along the way, many have wondered what the heck the developers were thinking.“Why would you list 63 different ophthalmology exam findings on this drop down menu, and yet require us to free-text ‘enlarged tonsils’ every single time? It’s supposed to be a primary care EMR, for gosh sakes,” said Dr. Goodforyou, a physician who was noted to be running 90 minutes behind at the time of the interview. “Ever since moving to electronic medical records,” he added, “my charting has bitten the big one.”Patients and physicians have also been critical of the need for computers in the exam rooms, complaining that the screens introduce a barrier to personal communication.“It’s like talking to my teenager,” complained patient Mandy Mayhow, when asked about her impression of EMRs. “I feel like the doctor isn’t even there any more. I’m just talking to the back of a screen.”Dr. Goodforyou was no longer available to respond to Mayhow’s comment. His office manager, however, noted that he probably feels the same way.Again, the software developers were at a loss. “We were never asked to consider doctor-patient interaction or clinic flow in our product development,” said Murdoch. “We thought the goal was simply to try to maximize required visit documentation. It was all supposed to be a game.”