How can a hospitalist deal with 15-20 patient load?

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
L

laserbeam

Full Member
10+ Year Member
Joined
Mar 30, 2012
Messages
71
Reaction score
21
Members don't see this ad.
My goal is to become a hospitalist three years later. But the task of dealing with 15-20 patients a day is daunting to me. Right now our patient load cap is 10, already making me busy. If there is one very sick patient, or there is a couple of more admissions a day, that day will be out of control. Can any hospitalist here share with an intern about how to organize your day?
 
They don't have rounds, didactics, clinic, or other intern duties. They can eat lunch when they want, and just work.

Seeing 20 patients in ten hours gives you 30 minutes per patient.
 
DocDanny said:
They don't have rounds, didactics, clinic, or other intern duties. They can eat lunch when they want, and just work.

Seeing 20 patients in ten hours gives you 30 minutes per patient.
Click to expand...

They also do admissions during the day too.
 
smq123 said:
Depends on the hospital.

At the hospital where I did residency, the hospitalists admitted every single day....3-4 admissions per day was typical.
Click to expand...

Yup. At my hospital the hospitalists admit every day. Each hospitalist has a teaching team (2 interns, 1 senior resident, couple of students) and they stay until 9pm on call with the team every 4th day when the team admits. But they also admit on every single day except for the day they are post call with their teaching team. On regular days they are out by 6pm or before if they finish up their work.

They also get paid really, really, well for one week on and one week off schedule. 🙂

Overnights are covered by nocturnist who are there for admits and to put out fires.
 
laserbeam said:
My goal is to become a hospitalist three years later. But the task of dealing with 15-20 patients a day is daunting to me. Right now our patient load cap is 10, already making me busy. If there is one very sick patient, or there is a couple of more admissions a day, that day will be out of control. Can any hospitalist here share with an intern about how to organize your day?
Click to expand...

Wow, when I ran hospitalist service as chief resident, my personal patient load could be up to 30 patients and the total list was overseen by one attending and split amongst 4 residents. Total service at it's max was 75 patients. I also had clinic half a day too so generally I had 4 hours to see everyone. My attending didn't care when the notes were written, just that everyone got seen in a timely manner. Once you learn the person on the first day it's pretty easy to maintain the care.

This is what worked for me:

So first thing I would do was have my patient list and physically go see every patient for 2-3 minutes: "how was your night?, any thing I need to take care of?, hows your breathing, etc" Do my quick lungs, heart, edema, etc. and move on to the next. That way you can identify anyone who doesn't look good, is vomiting, short of breath, pain control, etc early in the day. Change any orders you need for the nurses and move on. Do all your discharge orders first.

Once everyone was seen then you can sit with the charts and the computer, review the labs, xrays and make any other med adjustments you need. Write all your notes. If you get an admit in the middle, write the admit orders so they get tucked in and cooking get to the full H&P later if you need to.
 
You'll get rapidly more efficient with experience. Combine the decrease in extra responsibilities with a broader knowledge base (so you're not spending near as much time looking things up, asking more focused questions during your history,etc) and larger patient loads become much easier to manage.

As for organizing your day now as an intern, there are many things that may help...some tips may not work within your hospital though so check with your senior residents too:

- dictate h&p's if you can. Even if you don't feel comfortable with it right away, I promise you that you can get more info into your note talking for 15 minutes than you can typing for the same amount of time.

- be more focused on your social history/family history/past medical...if you're in peds it's a rare 6 year old that needs a full birth history. If youre in IM, does it really matter if your 65 year old patient had their carpal tunnel release in 1978 or 1980? All too often I've seen interns spend ungodly amounts of time sifting through those sorts of details with patients at the expense of more important things that actually matter, thus making what should take 15 minutes last 30...

- your progress notes don't have to be perfect. They don't have to have every last detail of the plan...it's medicine, patients get sicker and plans change. What might have the perfect plan at 1030am may be absolutely wrong at 1045. The sooner you can get over being a perfectionist about your notes, the better. If you're anal about documentation, then addendums and interval updates are typically faster ways to get info into the chart

- ideally the majority of your notes should be done before rounds (this is program specific however). If you can be done or mostly done by that time the rest of your day will be much easier.

- after rounds, your priority should be orders and calling consults - but don't ever let orders for little things get in the way of not talking to consult services early - then discharges, then whatever else. And always make sure your checkout is up to date prior to whatever time checkout is even if still have a ton of other things to do. Giving checkout on time so that others can deal with the BS pages that interrupt your workflow is key to getting home at a reasonable hour.

- ask for help if you need it. Your fellow interns may be able to do easy things for you while you're in with a sick patient, your senior as well. The worst that can happen is that they're busy too, but you might as well ask. I personally hated being the senior asking if I could do anything to help, being told "no" then seeing my intern race off to put up notes in the chart or call for echo results.
 
I feel overwhelmed as a GP because some clinics have 30 patients a day. but luckily those places were too shady for me to even want to work at and the patient load to salary ratio drove me away. with high patient loads, I like an environment where I have some help, like maybe of med students, PA's, NP's, or residents or other doctors. it helps the day go by faster, like a breeze. Maybe as a hospitalist, you can work at a place with a residency program in place to get that sort of assistance. Also, you will be so much more proficient in medicine in 3 years, so im sure those 15-20 patients will go by fast and you may even get done early.
 
docu said:
I feel overwhelmed as a GP because some clinics have 30 patients a day. but luckily those places were too shady for me to even want to work at and the patient load to salary ratio drove me away. with high patient loads, I like an environment where I have some help, like maybe of med students, PA's, NP's, or residents or other doctors. it helps the day go by faster, like a breeze. Maybe as a hospitalist, you can work at a place with a residency program in place to get that sort of assistance. Also, you will be so much more proficient in medicine in 3 years, so im sure those 15-20 patients will go by fast and you may even get done early.
Click to expand...

A private practice hospitalist has a lot of help. They are called consultants.
 
We have two hospitals in town. For rounding, they do like it to be around 16 patients per physician, but one hospital was very busy - each hospitalist had 26-30 patients. It was crazy. Both have dedicated admitting physicians because the service often admits 15-20 patients every 12 hours. The busiest I heard was 36 in 12 hours, the slowest: 8. The outlying hospitals will admit and round by the same hospitalist and often they only admit 3-4 a day and round on 12-16.

Every hospital is different.. you need to figure out what the flow is for your hospital.
 
We have two hospitals in town. For rounding, they do like it to be around 16 patients per physician, but one hospital was very busy - each hospitalist had 26-30 patients. It was crazy. Both have dedicated admitting physicians because the service often admits 15-20 patients every 12 hours. The busiest I heard was 36 in 12 hours, the slowest: 8. The outlying hospitals will admit and round by the same hospitalist and often they only admit 3-4 a day and round on 12-16.

Every hospital is different.. you need to figure out what the flow is for your hospital.
 
The thing that saves the most amount of time is the note writing. You cannot really shave off too much time off the physical exam & interview etc but not having to justify all the changes you are going to make and just writing
"Uncontrolled HTN - Increase metoprolol"
is sweet compared to
"Uncontrolled HTN - Last 5 checks have shown BP to be in the range of 150s/75s. Given that he is a DMer, his ideal goal is < 130/80. Given that his pulse is consistently above 75, I believe he will be able to tolerate a higher dose of metoprolol.
Plan - Increase metoprolol"

🙂
 
michaelrack said:
A private practice hospitalist has a lot of help. They are called consultants.
Click to expand...

Sometimes in the form of admitting the patient with orders by phone at 2am including consults for renal, pulmonary, neurology, and surgery.

Which ensures that the in-house surgery resident sees the consult before the admitting hospitalist has seen the patient at all. 🙄

Not that this has every happened to me.
 
LucidSplash said:
Sometimes in the form of admitting the patient with orders by phone at 2am including consults for renal, pulmonary, neurology, and surgery.

Which ensures that the in-house surgery resident sees the consult before the admitting hospitalist has seen the patient at all. 🙄

Not that this has every happened to me.
Click to expand...

exactly. that is how things are done in the real world
 
FutureInternist said:
The thing that saves the most amount of time is the note writing. You cannot really shave off too much time off the physical exam & interview etc but not having to justify all the changes you are going to make and just writing
"Uncontrolled HTN - Increase metoprolol"
is sweet compared to
"Uncontrolled HTN - Last 5 checks have shown BP to be in the range of 150s/75s. Given that he is a DMer, his ideal goal is < 130/80. Given that his pulse is consistently above 75, I believe he will be able to tolerate a higher dose of metoprolol.
Plan - Increase metoprolol"

🙂
Click to expand...

That works in the real world but won't work in residency...at least at the one I'm at. They want to see your throught process and determine that you know WTF you're doing to their satisfaction. I've seen people get bitched at because they didn't calculate the Well's criteria for the patient when they were obviously having PE symptoms and they and the attending went down that whole road to later arrive at -- right thing to do in that situation was a CTA for PE, stat.....

The thing about hospitalist's here -- they're not writing up all the exhaustive note cards to be able to spout off minute details that a particular attending may find interesting...they report to themselves and have total responsibility for their patient's....Ours carry 12 to 15 and that's considered heavy. I've seen residents carrying 6-7 on a daily basis, doing it from memory and coordinating consults, discharges and doing daily admits all the while judged to be lacking in inpatient medicine. Your mileage may vary....
 
JustPlainBill said:
That works in the real world but won't work in residency...at least at the one I'm at. They want to see your throught process and determine that you know WTF you're doing to their satisfaction. I've seen people get bitched at because they didn't calculate the Well's criteria for the patient when they were obviously having PE symptoms and they and the attending went down that whole road to later arrive at -- right thing to do in that situation was a CTA for PE, stat.....

The thing about hospitalist's here -- they're not writing up all the exhaustive note cards to be able to spout off minute details that a particular attending may find interesting...they report to themselves and have total responsibility for their patient's....Ours carry 12 to 15 and that's considered heavy. I've seen residents carrying 6-7 on a daily basis, doing it from memory and coordinating consults, discharges and doing daily admits all the while judged to be lacking in inpatient medicine. Your mileage may vary....
Click to expand...

That was what I meant with the 2 different ways of writing the notes.
My residency was the same way i.e doesn't count if not justified 🙂
 
JustPlainBill said:
Ours carry 12 to 15 and that's considered heavy. I've seen residents carrying 6-7 on a daily basis, doing it from memory and coordinating consults, discharges and doing daily admits all the while judged to be lacking in inpatient medicine. Your mileage may vary....
Click to expand...

12-15 is extraordinarily light out in the community. My last gig had the hospitalists averaging 35-50 pts, and they would typically get hit with 15-20 admits/call.
 
Deeply appreciate all the great advice above - very encouraging.
 
50 would be a lot.
Maybe cross-covering 50 if you are the 1 hospitalist on at night would not be uncommon, but to carry 50 during the day would be a heavy hospitalist day job...
It does depend a lot on the hospital where you are.
The little community hospital near me has a nocturnist plus 3 hospitalists there during the day. I'm not sure how they handle the admits during the day.
The night guy told me he typically admits 4 or 5 during the night.
That would be totally doable for an attending.
Think about how much better and more efficient you guys are now than you were at the beginning of 3rd year of med school. You will become exponentially faster after another couple of years of residency and couple years as an attending. Don't worry. You can do it.
 
I am a hospitalist and have average 18 patients/days plus 1-5 admits/day.

For night shift I did 5-15 admits/shift plus clinical encounters (saw patients with SOB, hypotension,...)
 
laserbeam said:
My goal is to become a hospitalist three years later. But the task of dealing with 15-20 patients a day is daunting to me. Right now our patient load cap is 10, already making me busy. If there is one very sick patient, or there is a couple of more admissions a day, that day will be out of control. Can any hospitalist here share with an intern about how to organize your day?
Click to expand...


Ok i think i can answer this question, but i do have a 6 years of full-time hospitalist plus multiple hsopitals moonlighting experience...

Yes Hospitalists do see somewhere around 15-18 or more patients on the average day....

The hospitalist block schedule is usually 5 or 7 days stretch.... You carry the same patients (plus admissions, minus discharges) during this block.... The first day you do have to spend a bit more time understanding these patients trying to find out what had happened before you came on board... the rest of the days it becomes easier as you know these patients well....

You do not spend 30 mins seeing a patient, the average is 15-20 mins max for a follow up... The same stands for any internists office/ or working in any subspeciality... As your experience grows, you would spend 4-5 hours seeing about 15-18 patients for follow ups plus/minus an hour or two for discharges at the most.... Out of 12 hour shifts depending, it is 6-7 hours of patient contact and writing the notes.... The rest can be in waiting for new admissions or reviewing your labs/images etc, talking to the families/consultants or checking your e-mails or just browsing the internet ....

Now, not every day is the same, some days can be busier then others, but this is how the hospitalist routine goes around....

Mind it, most hospital based sub-specialists (Cardio, Renal, CC, Neuro etc) start their day, way before the hospitalists do, to finish on their overnight consults, then go back to the office see the scheduled patients, do procedures etc, then probably again come back and finish the rest of the consults.... and then perhaps take the night call every 3rd-4th-5th day etc .... Hospitalists are done 99% of the times, when they leave the hospital and finish their shifts.... So you do the math!
 
trppo said:
Ok i think i can answer this question, but i do have a 6 years of full-time hospitalist plus multiple hsopitals moonlighting experience...

Yes Hospitalists do see somewhere around 15-18 or more patients on the average day....

The hospitalist block schedule is usually 5 or 7 days stretch.... You carry the same patients (plus admissions, minus discharges) during this block.... The first day you do have to spend a bit more time understanding these patients trying to find out what had happened before you came on board... the rest of the days it becomes easier as you know these patients well....

You do not spend 30 mins seeing a patient, the average is 15-20 mins max for a follow up... The same stands for any internists office/ or working in any subspeciality... As your experience grows, you would spend 4-5 hours seeing about 15-18 patients for follow ups plus/minus an hour or two for discharges at the most.... Out of 12 hour shifts depending, it is 6-7 hours of patient contact and writing the notes.... The rest can be in waiting for new admissions or reviewing your labs/images etc, talking to the families/consultants or checking your e-mails or just browsing the internet ....

Now, not every day is the same, some days can be busier then others, but this is how the hospitalist routine goes around....

Mind it, most hospital based sub-specialists (Cardio, Renal, CC, Neuro etc) start their day, way before the hospitalists do, to finish on their overnight consults, then go back to the office see the scheduled patients, do procedures etc, then probably again come back and finish the rest of the consults.... and then perhaps take the night call every 3rd-4th-5th day etc .... Hospitalists are done 99% of the times, when they leave the hospital and finish their shifts.... So you do the math!
Click to expand...

Thanks! For the details of every patient (medication doses, lines, lab values, comorbidities, etc), do we just memorize them, or is there a way to organize them? I am always afraid that I will forget something. I guess maybe with EMR, things will be better (we are not fully computerized yet).
 
laserbeam said:
Thanks! For the details of every patient (medication doses, lines, lab values, comorbidities, etc), do we just memorize them, or is there a way to organize them? I am always afraid that I will forget something. I guess maybe with EMR, things will be better (we are not fully computerized yet).
Click to expand...

Yes, you do not need to memorize them, now a days almost all the hospitals have computerized systems/EMR's, and you can access the details like labs, MAR, PMH, VS etc etc from anywhere, even from your home...

The important thing is to utilize all the data in an efficient manner, so that you can come to a comprehensive plan to manage your inpatients well.
 
I'm an IM intern, and I've gotten better, but it STILL takes me so long.

We have a paper charting system. I lose HOURS looking for the chart, writing down labs, copying the huge 21 point problem list, and photocopying a note for sit down rounds.

I can't wait for us to go EMR.
 
DocDanny said:
I'm an IM intern, and I've gotten better, but it STILL takes me so long.

We have a paper charting system. I lose HOURS looking for the chart, writing down labs, copying the huge 21 point problem list, and photocopying a note for sit down rounds.

I can't wait for us to go EMR.
Click to expand...

Careful what you wish for. EMR in general sucks majorly esp for day to day patient care. I take paper charts any day. Takes me hours and hours to deal with EMR.
 
You mean they worked EVERY Saturday and Sunday night?
 
The weekends are when people often go out, and where there are shows and concerts.

Where I live there isn't much to do on a Tuesday evening but watch TV.
 
DocDanny said:
The weekends are when people often go out, and where there are shows and concerts.

Where I live there isn't much to do on a Tuesday evening but watch TV.
Click to expand...

Hmmm...perhaps. People tend to go out on the weekends because that's when they are off. If you are off on a Tues/Wed, then you'd go out then.

Then again, you may find that as you get older and have a family, that "going out to shows and concerts" takes a backseat to family/children activities.

At any rate, you're right that in some communities all the action happens on the weekends but in large cities, something's happening every night.
 
cabinbuilder said:
Careful what you wish for. EMR in general sucks majorly esp for day to day patient care. I take paper charts any day. Takes me hours and hours to deal with EMR.
Click to expand...
Doubtful that it'd be longer than paper... possibly a generational/training difference now that most med students are trained on EMR?
 
TheLesPaul said:
Doubtful that it'd be longer than paper... possibly a generational/training difference now that most med students are trained on EMR?
Click to expand...

Nope.

EMRs are not designed by physicians. So, a lot of times, the interface doesn't make sense. Or there's a glitch in the EMR that they didn't foresee, but they don't know how to fix, so there's a totally inefficient workaround that adds an extra 3 minutes to each patient. ("It's just a few extra clicks!") There's the inevitable lag time as you switch from one patient's chart to another. And then there's the bugs, the system crashes, the times when the screen inexplicably freezes for 2 minutes, when the printer decides to suddenly stop communicating with the EMR, etc.

Oh, and did I mention the times when the system decides to log you out for NO GOOD REASON, but you're still logged into the system "somewhere," so you can't log back in? So you have to call IT and wait on hold for 15 minutes until someone answers your call and resets your account? [/rant]

Thinking that just because you're younger and computer savvy will make the EMR faster than paper is wishful, naive thinking.

IT is not your friend. IT does not understand the physician workflow. IT does not WANT to understand the physician workflow. IT does not understand why the EMR might not be preferable to paper, and doesn't want to hear it from you. So don't buy their lies that "this will help make things more efficient." Because it's not true.
 
Maybe the reason why I'd like it is that I'm an intern.

So at this stage of training they want me to put down the entire 24 point problem list and justify decisions.

And basically, 23 of those problems are unchanged every single day. So alot of my mornings is rewriting the same thing.
 
smq123 said:
Nope.

EMRs are not designed by physicians. So, a lot of times, the interface doesn't make sense. Or there's a glitch in the EMR that they didn't foresee, but they don't know how to fix, so there's a totally inefficient workaround that adds an extra 3 minutes to each patient. ("It's just a few extra clicks!") There's the inevitable lag time as you switch from one patient's chart to another. And then there's the bugs, the system crashes, the times when the screen inexplicably freezes for 2 minutes, when the printer decides to suddenly stop communicating with the EMR, etc.

Oh, and did I mention the times when the system decides to log you out for NO GOOD REASON, but you're still logged into the system "somewhere," so you can't log back in? So you have to call IT and wait on hold for 15 minutes until someone answers your call and resets your account? [/rant]

Thinking that just because you're younger and computer savvy will make the EMR faster than paper is wishful, naive thinking.

IT is not your friend. IT does not understand the physician workflow. IT does not WANT to understand the physician workflow. IT does not understand why the EMR might not be preferable to paper, and doesn't want to hear it from you. So don't buy their lies that "this will help make things more efficient." Because it's not true.
Click to expand...

I totaly agree. I am completely computer saavy so this whole computer generation bull that the younger crew spouts is a load of crap. I use EMR every day, it is a miserable existance that I hate. I absolutely refuse to click boxes and will only work a job that I can dictate because I am already so bogged down trying to navigate EMR for labs, med lists, allergies, and consults that have come through there is NO WAY I would ever have time to do the chart notes too along with doing ER/LTC/IP everyday along with clinic.
 
smq123 said:
Nope.

EMRs are not designed by physicians. So, a lot of times, the interface doesn't make sense. Or there's a glitch in the EMR that they didn't foresee, but they don't know how to fix, so there's a totally inefficient workaround that adds an extra 3 minutes to each patient. ("It's just a few extra clicks!") There's the inevitable lag time as you switch from one patient's chart to another. And then there's the bugs, the system crashes, the times when the screen inexplicably freezes for 2 minutes, when the printer decides to suddenly stop communicating with the EMR, etc.

Oh, and did I mention the times when the system decides to log you out for NO GOOD REASON, but you're still logged into the system "somewhere," so you can't log back in? So you have to call IT and wait on hold for 15 minutes until someone answers your call and resets your account? [/rant]

Thinking that just because you're younger and computer savvy will make the EMR faster than paper is wishful, naive thinking.
Click to expand...
I'm not trying to be offensive, but most of those glitches sound like they're user errors. I see a lot of my fellow residents mashing buttons and complaining about glitches that I've never encountered. There are tons of options that they don't even know exist but would greatly facilitate their lives.

I agree that the EMR wasn't designed specifically for the physician, but you can manipulate it to your benefit. It is infinitely faster than the paper chart when I'm trying to find someone's cardiac cath report from 1998. You can't even argue that. Documenting a quick note might take longer, and submitting an electronic prescription may well take longer than writing a quick script and handing it to them, but it's much easier to retrieve down the road.
 
cabinbuilder said:
I totaly agree. I am completely computer saavy so this whole computer generation bull that the younger crew spouts is a load of crap. I use EMR every day, it is a miserable existance that I hate. I absolutely refuse to click boxes and will only work a job that I can dictate because I am already so bogged down trying to navigate EMR for labs, med lists, allergies, and consults that have come through there is NO WAY I would ever have time to do the chart notes too along with doing ER/LTC/IP everyday along with clinic.
Click to expand...
Of course it's easier to scribble a quick progress note in the chart ("bone still broke, surgery pending cardiac clearance") than it is to find an available computer, log in, select the patient, open a new note, type it out, sign it, close out of the chart/computer.

But that doesn't mean that overall an EMR couldn't be designed to be more efficient overall. If you carry around your own little tablet, can sync into the system, instantly access previous records, look at their labs/vitals/etc on a well-organized worksheet, you could be just as efficient, and all of your documentation would be easier for everyone else to read, easier for other people to access without having to walk up to the floor to read (I really don't enjoy walking around to various charts to see if the consultant has been by yet), and it would be permanently preserved in the patient's medical record.
 
TheProwler said:
I'm not trying to be offensive, but most of those glitches sound like they're user errors. I see a lot of my fellow residents mashing buttons and complaining about glitches that I've never encountered. There are tons of options that they don't even know exist but would greatly facilitate their lives.
Click to expand...

It depends greatly on where you're working, and their attitude to EMR.

The hospital where I did residency used Soarian Smart Chart. IT had some weird thing where physicians were not allowed to create or use templates. There were a lot of glitches that IT admitted were glitches, but claimed to be "powerless" to fix.

These were not user errors. It was a bad interface in a system where there was little-to-no help for physicians actually using it.

In the long run, yes, EMR helps OVERALL. But in the day-to-day setting of seeing patients, EMR does not make your day faster. Any advantage you gain by being able to easily retrieve a cath report is quickly lost by the computer crashing, the system crashing, or some other issue that slows you down.
 
yeah, no one has ever spent 5 minutes looking for a physical chart because some social worker had it somewhere else on the unit and no one ever had to wait for some other service/ person/nurse to get finished with a chart before you could use it- it's also assuming that all the physical paper data gets collated into the chart in a reasonable process and that there aren't multiple charts in multiple places to gater up

Until I see some kind of data that one is faster than the other in some kind of real-use scenario I'm not buying the fastness of paper charting
 
TheLesPaul said:
Out of curiosity, what EMR do you use? I've found EPIC to be excellent.
Click to expand...

I used NextGen as outpatient and Soarian Smart Chart as inpatient. I use Sage Intergy now.

There's just a lot of annoyances with EMR that never came up on paper. Like I can't send prescriptions electronically because my DEA wasn't entered - although why that matters on non-controlled substances is something that hasn't been explained to me. I get calls from pharmacies and labs because my name was misspelled, but it takes 2 weeks for the IT people to fix it. Or there's duplicate charts because someone didn't realize the patient was already in the system, and there's no way to seamlessly merge the charts. Or certain orders don't go through because I don't have a Medicaid number yet. You can only renew one prescription at a time and there is an interaction checker you need to approve after every single prescription. Updating the family hx with something obscure (like sarcoidosis or MS) takes 5 minutes. It's the little things that add up. Yeah, it's nice not to have to fight over charts or go looking for charts, but all the other little things make up for it.
 
TheLesPaul said:
Out of curiosity, what EMR do you use? I've found EPIC to be excellent.
Click to expand...

So far, EPIC is the worst. A nearby university hospital switched to EPIC, and their discharge notes are terrible. Every Pt comes to us w two different discharge med lists.
Did this happen w you guys ?
 
Last edited:
My experience with EPIC is that it's very install dependent. When installed well, it works reasonably well. There are lots and lots of things that need to be "optimized". Theoretically that makes it very flexible, but also opens it up to all sorts of problems.
 
Mattchiavelli said:
yeah, no one has ever spent 5 minutes looking for a physical chart because some social worker had it somewhere else on the unit and no one ever had to wait for some other service/ person/nurse to get finished with a chart before you could use it- it's also assuming that all the physical paper data gets collated into the chart in a reasonable process and that there aren't multiple charts in multiple places to gater up

Until I see some kind of data that one is faster than the other in some kind of real-use scenario I'm not buying the fastness of paper charting
Click to expand...

for many small physician offices, paper charting is faster.
 
michaelrack said:
for many small physician offices, paper charting is faster.
Click to expand...
Agreed. I rotated with a pediatrician in private practice who used paper charting, and it seemed pretty simple. He walked in with a folder that contained everything in the kid's history, filled out a little template for each new office visit or wrote a paragraph, and done.

The current setup with EMRs often involves printing out their last office note or two and sticking it in the door (not exactly saving trees). A single folder with everything can be a lot simpler.
 
You must log in or register to reply here.

Similar threads

L
Applying for R positions in Anesthesia programs while working as a Hospitalist
Replies
1
Views
538
CopaceticOne
CopaceticOne
W
Can I apply without ECFMG Certification?
Replies
8
Views
1K
Gonio5
G
U
On vacation in a different state, can I prescribe?
Replies
30
Views
3K
CopaceticOne
CopaceticOne
N
PGY1 Non-Renewal – Better to Leave at 12 Months or Stay to 15?
Replies
16
Views
2K
mistafab
mistafab
Aylaa
  • Locked
How can I become involved in starting a new fellowship?
Replies
3
Views
3K
operaman
O
Top