This is directed to all medical students, residents, and attendings in psychiatry. Has your hospital fully implemented the EMR? Specifically, are you required to type (not write or dictate) all admissions, daily notes, and discharge summaries?
I'm not one of the old guard Luddites (of which we have a few on staff), but it can be frustrating, even for the computer literate. I refuse to type notes and interact with the computer whle I'm interviewing the patient
a universal EMR system
I've wondered this could be a good way to catch those types of patients that go from hospital to hospital one the former one figures out they got something such as malingering or factitious.
I had one patient who comes in about every week after he went on a cocaine binge-until he uses up all his welfare money. He would fake suicidal ideation to get in. We stopped admitted him because he was basically using the hospital as a way to get free food until his next welfare check.
So then I'm visiting a buddy at another hospital one day and cocaine-malinerger man is over at that hospital! He figured out he couldn't use us, so he went over to the next county.
The guy has it down to a science. Once he's worn out his welcome, he just gravitates to one of 3 counties which are easily accessible by bus. Then by the time he's on his 3rd, he'll go back to the 1st, and because they haven't seen the guy in a few months they're willing to take him in again.
If we had a universal record system, we'd be able to catch these people. None of the 3 hospitals talk to each other. I only found this out after about 2 years and occasionally talking to staff & residents from the other places.
Ya, ya wishful thinking.
We had a grand rounds on this same subject, done by a family practice doctor who mentioned his frustration on dealing with recently discharged patients with no discharge summary because docs got 1 month to do the DS.
So he gets a patient 1 week after discharge and he doesn't know why they're on the meds they were prescribed. The patient doesn't either. So he asks the hospital for a DS, and it won't be ready for several days.
I mentioned the flashdrive idea.
His response...
The problem with a flashdrive is the very patients that cause the frustration are the same people that wouldn't carry a flashdrive. The "responsible" patients usually know why they're on their meds & have fairly good insight.
The "other" patients show up to the ER fairly often--and with no idea on what they're on. They just know they need help because they got something like chest pain.
Ahh, the classic "I dont know why I am here" patient.