I love our epic anesthesia record

[caligas]

it took me a while to come around and it was stressful at first, but it's fantastic now. Looking at the full, time condensed record at the end of an anesthetic, it is a thing of beauty. (Can't be said for my sloppy hand charting).

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[Mman]

it took me a while to come around and it was stressful at first, but it's fantastic now. Looking at the full, time condensed record at the end of an anesthetic, it is a thing of beauty. (Can't be said for my sloppy hand charting).

I hate epic. Far worse than other computer charting systems IMHO, though if you are coming from paper it's obviously an improvement.

 

[caligas]

I hate epic. Far worse than other computer charting systems IMHO, though if you are coming from paper it's obviously an improvement.

Yes, I have nothing to compare it to, besides hand cramps.

 

[ZzzPlz]

Loved epic where I trained. Now we have it everywhere except no intra-op epic. It's like having all the pig **** without the bacon.

 

[fakin' the funk]

We have had full Epic including intra-op across multiple hospitals for 3-4 years now. Epic is a beast.

It is a HUGE time saver once you get the hang of it. I have multiple customized macros for physical exam, plans, smartphrase notes. Automation with customizable flexibility.

And the other components of Epic like history/problem lists, I/O's, the MAR are a huge plus for getting all the info you need quickly.

 

[Planktonmd]

We have had full Epic including intra-op across multiple hospitals for 3-4 years now. Epic is a beast.

It is a HUGE time saver once you get the hang of it. I have multiple customized macros for physical exam, plans, smartphrase notes. Automation with customizable flexibility.

And the other components of Epic like history/problem lists, I/O's, the MAR are a huge plus for getting all the info you need quickly.

You get all the info you need buried in a pile of crap you don't need.

 

[Mman]

The problem with epic's anesthesia module is that it's merely a version of their ICU nurse charting that they call an anesthesia record. Want to chart that you gave a bolus dose of a drug? I bet it takes you at least 5 or 6 clicks even if it is merely the same redose of NMB or opioid you gave 30 minutes ago. It's inefficient. Got an emergency case crashing into the OR? You better make sure you take the time to log in and identify the patient or it will not track any vital signs. Hope it isn't time for your password change or it could take a little longer.

 

[sigrhoillusion]

The problem with epic's anesthesia module is that it's merely a version of their ICU nurse charting that they call an anesthesia record. Want to chart that you gave a bolus dose of a drug? I bet it takes you at least 5 or 6 clicks even if it is merely the same redose of NMB or opioid you gave 30 minutes ago. It's inefficient. Got an emergency case crashing into the OR? You better make sure you take the time to log in and identify the patient or it will not track any vital signs. Hope it isn't time for your password change or it could take a little longer.

Ehhh... Our EPIC is tied to the monitors. PICU/NICU kids can be transported throughout the hospital and as soon as you plug that monitor into EPIC it will populate all their data from the transport. Urgent/emergent case cn be documented and then transferred to that patient's record once their chart is compiled. We get either 10 or 15 day notices whenever our EPIC/pyxis/organization passwords are going to expire. So if we can't log in during an emergency it's really only our own fault for being lazy.

Could it be better? Sure. Could it be worse? Probably. But it's accurate, fast and usually reliable. Benefits of academia I guess

 

[fakin' the funk]

The problem with epic's anesthesia module is that it's merely a version of their ICU nurse charting that they call an anesthesia record. Want to chart that you gave a bolus dose of a drug? I bet it takes you at least 5 or 6 clicks even if it is merely the same redose of NMB or opioid you gave 30 minutes ago.

It takes 3 clicks to chart a redose (or any of the 3 "most common" doses). You say "I bet it takes at least 5 or 6 clicks" -- do you use Epic? Why do you have to wager?

Got an emergency case crashing into the OR? You better make sure you take the time to log in and identify the patient or it will not track any vital signs. Hope it isn't time for your password change or it could take a little longer.

Our Epic system works by linking the anesthesia record to a given monitor. As long as the vitals are still "in" the monitor -- as they would be if you rolled into an OR with a crash -- you can establish the "link" later and still retrieve the vitals.

I offer Epic weekend courses for $2100 every 10 years recertification or $210/yr. CME pending

 

[IlDestriero]

We switched to epic. I think it works fine. And yes, redose, or a dose of a drug that is in the pre populated custom macro is 3 clicks.
It's value is that it collects all the data right there for you to see. Labs, MAR, radiology, clinic or consult notes, etc. We used to have a pretty easy to use electronic anesthesia record, but it didn't talk to epic, so NPs had to enter data, or us, and we had to look it up in another format. It sucked for complex patients. Cardiac notes and echoes were in one place, radiology images another, clinic and inpatient notes in a 3rd, etc. 3 systems, 3 logins, etc.


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Il Destriero

 

[Mman]

It takes 3 clicks to chart a redose (or any of the 3 "most common" doses). You say "I bet it takes at least 5 or 6 clicks" -- do you use Epic? Why do you have to wager?


Our Epic system works by linking the anesthesia record to a given monitor. As long as the vitals are still "in" the monitor -- as they would be if you rolled into an OR with a crash -- you can establish the "link" later and still retrieve the vitals.

One of the hospitals we cover uses Epic. The answer as to how easy those things works depends on which version of Epic you use and how much customization has been done. It's a god awful system to customize and every hospital that uses it has their own unique version that isn't transferrable between facilities (unless they are on the same hard wired system).

 

[rakotomazoto]

Epic or not, it's charting, aka paperwork. Every health record requires wading through a ocean of information trying to find the relevant pearls. The only scenario where charting would not be a hassle would be if the hospital hired a scribe to just follow me around and chart as we go. There would have to be some rules about what to document and what to ignore, charts need to be appropriately buffed, after all. I would get him/her a classy outfit to wear, probably something with a cape, maybe a fancy hat.

But since that will never happen, Epic is not all that bad. I prefer it over Orchid/Centricity and paper charting which is all the systems I have used so far, but to each his or her own. I do like how much I can customize Epic at my institution, although I don't take advantage as much as I could/should. I agree with Mman, Epic is only as good as the version at your institution.

I hear people dream about systems where you would scan every med's barcode label rather than manually documenting drugs yourself, in the name of efficiency. I think this would be more of a headache than helpful personally. I feel like it would force everyone to use standard dilutions and concentrations and getting the whole department/group to agree on what the "standard" concentration of phenylephrine will be sounds like too much drama. Plus, you would have to do a whole different set of labels for pediatric dilutions somehow.

 

[Ronin2258]

Had Epic at one of my training sites. It went online to the WHOLE hospital care system on the same day. We all had to be trained prior to it going online.

I was rotating on chronic pain at the time. The day it went online, I swear one of my attendings looked like she was about to kill something (aside from me, fortunately.) It was bad enough the first day that I ended up starting interviewing her private patients just to help her keep up. She walked into one room like she was reaching for the twin six-shooters slung on her hips ready to shoot anything with a computer attached to it. During lunch, I saw some more frustrated people fretting about it.

I would still rather have Epic (fail) than a paper chart. It at least unified the hospital. It definitely got better after a while.

For the OR, I was personally a fan of SIS. Thing acted like a paper chart, and felt like it was designed with us in mind. But it had the clarity and permanence of a computer record.

The thing of it is, most of these systems are designed by engineers and computer programmers, with more attention paid to the backside (record tracking, algorithms, etc.) than the user interface. I personally thought they could include a few more people from the specialties that use it for intense recording as we do.

 

[Laryngophed]

We use another common EMR. It's like anything else. There are some things it is great for, others not so much. In no way would I say that electronic charts are better than paper for short quick cases, but I can't say that I'm sad that I missed the days of doing hearts on paper. The anesthesia record of the EMR is pretty solid. At least the iteration we see. But we are also a test site for our EMR developer, so we also get to see some piecemeal "upgrades" that are essentially being beta tested by us.

 

[vector2]

In no way would I say that electronic charts are better than paper for short quick cases, but I can't say that I'm sad that I missed the days of doing hearts on paper.

How is EMR not better for short cases? I can actually spend time taking care of the patient and getting ready to wake them up in a couple minutes instead of drawing ^><~ and manually writing in all the other garbage on paper

 

[deleted171991]

How is EMR not better for short cases? I can actually spend time taking care of the patient and getting ready to wake them up in a couple minutes instead of drawing ^><~ and manually writing in all the other garbage on paper

I used to do short cases in Epic. Time to chart was much less than the paper record. But I am good. At charting.

 

[sigrhoillusion]

I used to do short cases in Epic. Time to chart was much less than the paper record. But I am good. At charting.

Yea, EPIC is great for short cases. Peds ENT rooms. If you're supervising one person manages the other charts. If by yourself you manage, and then fill in the chart later sans the Vitals since they are auto-populated. Pre and post op are usually check boxes.