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We heard you the first time.
Epic EMR what are your thoughts medical students?
- Thread starter PieOHmy
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I think a significant part of the problem is that we have significantly misunderstood what professionalism should be.
I am not a surgeon, but as I understand it, surgeons will consider that they have not just a right, but a professional obligation to insist on good tools and an appropriate environment for them to carry out their surgery in. If the operating table is too low, you don't just shrug, hunch your back, deal with the resulting back pain, and try to operate despite it. You raise the table to the appropriate height so that you can perform the surgery optimally. If the lighting isn't right for you to see what you are doing, you fix the lighting, you don't just operate in the dark. If your scalpels aren't sharp enough, you don't just mash the dull blades into your patient's flesh, you insist on sharp scalpels. A single surgeon from a highly paid specialty being hired will not infrequently insist on tens or hundreds of thousands of dollars in equipment that they want purchased for their own use, because that's the equipment they feel they can best work with. This is not done because they are divas, but because this is how they make sure they do right by their patients.
For those of us working in a more cognitive specialty, the EMR is one of our major tools. Especially when dealing with complex patients who are being cared for by multiple physicians and other health professionals and who have had a long medical course, the medical record with all of its strengths and weaknesses become a huge part of the patient's care, for good or (more often) for ill.
What has been our response to the undeniable fact that the key tool that many of us use to care for our patients is a flaming pile of excrement? It has, by and large, been to consider that being professional, being a good team player means going along with this. Maybe grumbling about it with colleagues over drinks, maybe writing the odd op-ed about how much we wish things were different. But at the end of the day, we have conceived of our professional responsibilities as demanding that we not rock the boat, not demand for better. We have accepted that our OR table is too low, the lighting is terrible, and our scalpels are too dull. We are practicing medicine metaphorically hunched over, backs screaming in pain, squinting into the darkness, and mashing dull blades into the flesh of our patients, who surely deserve better than this.
I would propose we re-think what professionalism should demand of us here, and to consider that perhaps it doesn't prioritize being a team player who doesn't make life difficult for the administrators, the IT department, and the EMR vendors. Professionalism should prioritize doing what's right for our patients, which means pushing, forcefully if need be, for better tools.
There is no virtue in being willing to operate in the dark outside of some sort of disaster scenario; it doesn't make you a good team player, it doesn't mean you are resilient, it doesn't reflect well on your adaptability or your skills. It just means that you lack judgement and a willingness to stand up for your patient and yourself. Until we develop the same mindset about working with a terrible EMR, we will continue to see significant avoidable harm visited upon our patients and ourselves.
(from bearded pete on reddit)
I am not a surgeon, but as I understand it, surgeons will consider that they have not just a right, but a professional obligation to insist on good tools and an appropriate environment for them to carry out their surgery in. If the operating table is too low, you don't just shrug, hunch your back, deal with the resulting back pain, and try to operate despite it. You raise the table to the appropriate height so that you can perform the surgery optimally. If the lighting isn't right for you to see what you are doing, you fix the lighting, you don't just operate in the dark. If your scalpels aren't sharp enough, you don't just mash the dull blades into your patient's flesh, you insist on sharp scalpels. A single surgeon from a highly paid specialty being hired will not infrequently insist on tens or hundreds of thousands of dollars in equipment that they want purchased for their own use, because that's the equipment they feel they can best work with. This is not done because they are divas, but because this is how they make sure they do right by their patients.
For those of us working in a more cognitive specialty, the EMR is one of our major tools. Especially when dealing with complex patients who are being cared for by multiple physicians and other health professionals and who have had a long medical course, the medical record with all of its strengths and weaknesses become a huge part of the patient's care, for good or (more often) for ill.
What has been our response to the undeniable fact that the key tool that many of us use to care for our patients is a flaming pile of excrement? It has, by and large, been to consider that being professional, being a good team player means going along with this. Maybe grumbling about it with colleagues over drinks, maybe writing the odd op-ed about how much we wish things were different. But at the end of the day, we have conceived of our professional responsibilities as demanding that we not rock the boat, not demand for better. We have accepted that our OR table is too low, the lighting is terrible, and our scalpels are too dull. We are practicing medicine metaphorically hunched over, backs screaming in pain, squinting into the darkness, and mashing dull blades into the flesh of our patients, who surely deserve better than this.
I would propose we re-think what professionalism should demand of us here, and to consider that perhaps it doesn't prioritize being a team player who doesn't make life difficult for the administrators, the IT department, and the EMR vendors. Professionalism should prioritize doing what's right for our patients, which means pushing, forcefully if need be, for better tools.
There is no virtue in being willing to operate in the dark outside of some sort of disaster scenario; it doesn't make you a good team player, it doesn't mean you are resilient, it doesn't reflect well on your adaptability or your skills. It just means that you lack judgement and a willingness to stand up for your patient and yourself. Until we develop the same mindset about working with a terrible EMR, we will continue to see significant avoidable harm visited upon our patients and ourselves.
(from bearded pete on reddit)
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It's very much deniable.
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Definitely not hyperbole at all lol.
I agree that EMRs are not great, but they are a large improvement over paper records in most cases. Know people who worked with paper records and from what they showed me the writing was quite literally illegible. I don't even want to know how many medical errors were caused by paper records prior to EMR in the past but I assure you that there is no way EMR could possibly be worse. As far as which EMR, that comes down to preference. Do you want your EMR to communicate with other hospitals in the area virtually seamlessly? Do you want it to look nice, and be easy to use? Do you want it to be easy to find a broad superficial picture of a patients history in a single page? Do you want it to be highly customizable so it works better for you? Then EPIC is probably the best. If you want it to look/function like something out of the 70s, you work in the VA, if you want the 80s, you get meditech, 90s then Cerner.
If you really hate EPIC that much, feel free to get a job somewhere that doesn't have it, but I assure you it will likely be there in the not-too-distant future because the vast majority of EMR users like EPIC better.
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This medical student's opinion on EPIC:
It would genuinely change my rank list if a school I was on the fence on had EPIC as opposed to Cerner.
It would genuinely change my rank list if a school I was on the fence on had EPIC as opposed to Cerner.
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This medical student's opinion on EPIC:
It would genuinely change my rank list if a school I was on the fence on had EPIC as opposed to Cerner.
I HATE cerner and it definitely goes in the cons column for my ROL
In order to speak of something, you have to know a little something about it.
You are condemning paper charting yet admit to never have used paper records.
I lived through both. I cant do ANYTHING efficiently with an EMR.
I am in a sorta practice where I have to choose between pay attention to my patient or fight with EMR.
I cant find anything fast on EPIC.
IT IS PURE GARBAGE
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Your ability to do things efficiently should be weighted against patient safety. The simple fact of the matter is that forcing other healthcare providers (consulting physicians, nurses, and pharmacists) to read your handwriting puts patients in danger. Of all the paper charts I have needed to read during my work, only 10% of them are completely legible without any need to utilize context clues.
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Yep. Mayo converted from Cerner to Epic at a cost of $1.5B.
Mayo Clinic completes Epic EHR rollout with final go-lives
With a proverbial flip of the switch at three locations in Florida and Arizona, Mayo Clinic has completed its $1.5 billion Epic electronic health record implementation, linking all Mayo sites on an integrated EHR and revenue cycle management system. WHY IT MATTERS The Mayo Clinic rollout, called...
www.healthcareitnews.com
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That’s why Epic can afford to pay people $70k right out of college with no programming experience
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I recall during internship and residency, lining up outside the lab waiting for the lab results, which are slips of paper that the lab techs wrote on and placed in the pigeon hole slots outside the lab. So guess if I like EMR or not….
The quality of information in the chart, whether the old paper chart or EMR, is entirely dependent on the people entering the information. Chart bloat comes from people too lazy and just copy and paste other peoples notes into their notes. Such notes are useless.
When I see a patient for the first time as a consultant in the hospital, I will write (type) my note in its entirety. I know what is going on with the patient, my thought process, my assessment and plan. It is the note I go to for information when I see the patient in clinic. Sure, this takes time initially, but saves time later. Same in the ICU, including the hospital course, summarized, so when the patient leaves, my colleagues don't have to dig through days of information. Charting etiquette is importing.
As for EPIC, it is much better than others, and I have used Epic since 2007. I have customized my notes, short cuts and preference lists for orders so it is easy for me, whether in clinic, the wards or ICU. I know where to get information easily. Definitely better than the old paper charts.
The quality of information in the chart, whether the old paper chart or EMR, is entirely dependent on the people entering the information. Chart bloat comes from people too lazy and just copy and paste other peoples notes into their notes. Such notes are useless.
When I see a patient for the first time as a consultant in the hospital, I will write (type) my note in its entirety. I know what is going on with the patient, my thought process, my assessment and plan. It is the note I go to for information when I see the patient in clinic. Sure, this takes time initially, but saves time later. Same in the ICU, including the hospital course, summarized, so when the patient leaves, my colleagues don't have to dig through days of information. Charting etiquette is importing.
As for EPIC, it is much better than others, and I have used Epic since 2007. I have customized my notes, short cuts and preference lists for orders so it is easy for me, whether in clinic, the wards or ICU. I know where to get information easily. Definitely better than the old paper charts.
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We made a transition from paper to Epic in October 2018. Pre Epic, I could not get any information about my patient until I spoke to the surgeon or got actual possession of the physical chart. With Epic I have access to all the notes, labs, echo, Cath reports, xrays, ct, etc, anytime and anywhere from my laptop (via Citrix) and my phone (via Haiku). I consider that an improvement.
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Have you tried Control+Spacebar?
