Extraneous Paperwork

[docB]

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I am so sick of all the extraneous paperwork I have to fill out, a special form for the psychs, the work comp form, a special form for the prisoners, a special form for the boxers. I especially hate work notes. I?m continually amazed that employers won?t trust their employees but will trust something that I scrawl in a hurry and sign illegibly. We already spend too much time documenting to avoid liability risk. I certainly don?t see this getting better any time soon.

 

[edinOH]

extraneous paperwork = oxymoron

 

[Sessamoid]

I agree. All paperwork in medicine is extraneous. The amount of useless paper we have to generate merely to get paid for the work that we perform anyway is insane. It only gets worse over time, because nobody actually reduces paperwork (despite the federal act called the "federal paperwork reduction act"), despite the gov't trying to pay us less and less.

 

[docB]

extraneous paperwork = oxymoron

Did you mean oxymoron or redundant term? I thought an oxymoron was a marriage of two terms that cancel each other out like "military intelligence." I agree that it's totally redundant.

 

[edinOH]

I stand corrected. Redundant. I stand corrected. Redundant.

 

[docB]

And speaking of life getting worse in general (in terms of paperwork) JACHO just squirmed through my neck of the woods so now nothing can be abbreviated, verbal orders are verboten and everything basically sucks a little more.

 

[SaltySqueegee]

And speaking of life getting worse in general (in terms of paperwork) JACHO just squirmed through my neck of the woods so now nothing can be abbreviated, verbal orders are verboten and everything basically sucks a little more.

In other people's experience, what is being done about paperwork in the way of moving towards digital documentation?

... typing seems a lot faster and generally more efficient.

 

[Febrifuge]

The ED where I work uses an all-computerized system. Charting, ordering and completion of everything from labs to CT to procedures... all on computer. It rocks. Sadly, the day I need to work in a place with actual charts I will look like a total boob.

 

[Sessamoid]

In other people's experience, what is being done about paperwork in the way of moving towards digital documentation?

... typing seems a lot faster and generally more efficient.

I type anywhere between 60-100 wpm, and it's nowhere near as fast as dictation. It's also not as efficient as a good paper template system. Moving to digital documentation involves a LOT of retraining physicians, many of whom are pretty old and technophobic. It also involves a lot of money, which many cash-strapped hospitals can't afford. You'll see it first in really rich hospitals sitting on piles of cash (i.e. not many).

 

[docB]

Right now I'm the director for implementation of a new electronic charting, order, record, etc. system at one of my ERs. It will clearly have a lot of ups and downs. The retraining will certainly be an issue and billing will likely have some problems. We'll see.

 

[USCDiver]

I type anywhere between 60-100 wpm, and it's nowhere near as fast as dictation. It's also not as efficient as a good paper template system. Moving to digital documentation involves a LOT of retraining physicians, many of whom are pretty old and technophobic. It also involves a lot of money, which many cash-strapped hospitals can't afford. You'll see it first in really rich hospitals sitting on piles of cash (i.e. not many).

Ah, yes, but can you do something else while dictating? In my experience, dictating docs are indisposed. Any interruption causes them to stop their dictating. On the other hand, I can type in an HPI and click through a physical exam while carrying on a reasonably coherent conversation.

 

[SaltySqueegee]

Ah, yes, but can you do something else while dictating? In my experience, dictating docs are indisposed. Any interruption causes them to stop their dictating. On the other hand, I can type in an HPI and click through a physical exam while carrying on a reasonably coherent conversation.

Ah, yes. Multi-tasking. This is very true, and the sheer number of times I have seen the ER Doc that I've shadowed become interrupted is numerous. Being able to fill out electronic forms and click save every now and then seems like a good thing to me.

Possibly a transition period is necessary. Wherein the electronic version is available to use for the docs, but if they wish, they can use the Dictation service in a pinch (wherein the transcriptionist inputs the saved voicemail into the same system).

Thoughts?

Also, what are the financial costs of implementing a system like this? Is it mostly IT overhead? The Hardware costs don't seem to be as much the problem as the long term maintenance of the electronic system.

 

[Sessamoid]

Possibly a transition period is necessary. Wherein the electronic version is available to use for the docs, but if they wish, they can use the Dictation service in a pinch (wherein the transcriptionist inputs the saved voicemail into the same system).

Thoughts?

Also, what are the financial costs of implementing a system like this? Is it mostly IT overhead? The Hardware costs don't seem to be as much the problem as the long term maintenance of the electronic system.

I'd be up to trying it, but the hospital can't afford it. The computers in the ED top out a 233 Mhz max. The software systems are not cheap at all. The cost of the software and upkeep dwarfs the hardware costs probably by a factor of 100 or more. Retraining costs a lot too.