Programs that still use paper charts
- Thread starter MD13
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last I heard Grady did.
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I think Indiana still has paper charts if I recall from the interview day.
Resurrection in Chicago did/does, but will be implementing Epic for this coming years intern class, I believe.
Resurrection in Chicago did/does, but will be implementing Epic for this coming years intern class, I believe.
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why would you want to use paper charts? they will be dinosaurs very shortly, and you're better off learning to be efficient w/ an EMR... learning the next one is so much easier!!!
cook county still uses paper for the main ED part of the chart as far as i know... cerner/firstnet for the rest.
lol, I DONT want to use paper charts! That's why I want to make a list..I figured that a list of programs that still use paper would be shorter than the list of EMR programs..
The list will probably help me narrow down programs to some extent..I HATE paper charts for one, and also a program still using paper charts reflects poorly on its ability to adapt with the times..
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Maryland and LSU-NO come to mind, but I think LSU is getting an EMR this summer.
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Many programs claim to be "getting an EMR soon". Something only to be believed once it actually happens.
In my experience via rotations/interviews:
-Georgetown uses paper charts for H&P, nursing orders, med orders, rads orders, and all else.
-USC/LA County uses paper charts for H&P, nursing orders, med orders. Computer entry for radiology orders.
-UCLA/Harbor is on a paper system still as well (must be a Los Angeles County thing)
-If I remember correctly, Maricopa uses EMR for most, but physician orders are still hand written.
Can't clearly enough recall any others.
In my experience via rotations/interviews:
-Georgetown uses paper charts for H&P, nursing orders, med orders, rads orders, and all else.
-USC/LA County uses paper charts for H&P, nursing orders, med orders. Computer entry for radiology orders.
-UCLA/Harbor is on a paper system still as well (must be a Los Angeles County thing)
-If I remember correctly, Maricopa uses EMR for most, but physician orders are still hand written.
Can't clearly enough recall any others.
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I think most hospitals that still use paper charts don't do it out of preference but rather financial or political constraints of the hospital. Harbor-UCLA for example uses paper charts for documentation but just got electronic discharge instructions/paperwork and an electronic patient board (Wellsoft). I'm not sure how much Wellsoft integration will eventually occur (as it has electronic documentation and order entry capabilities and such -- we will see with the new ED I suppose). However, all of the UCLA-affiliated hospital Emergency Departments I have rotated through (Harbor-UCLA, Ronald Reagan, Olive View) all use paper to document the encounter, but electronic discharge and patient signup (and at Reagan, electronic order entry).
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ahhh makes sense.
well part of the negative w/ any county-type program is that $$ is always, always an issue. cook county's department of EM does a good job of getting $$ for things the RESIDENTS need (like glidescope, US machines, nasopharyngoscopes, etc).... but the hospital system is a different story. though, the rest of the hospital was implementing computerized notes when i finished.
maybe a certain current Cook resident can chime in, but imho the ED paper charts are still there b/c:
1. hospital doesn't want to spend $$ to upgrade to full EMR in Cerner/FirstNet (my current gig has it, it's functional, but best used w/ Dragon or the like)
2. they had a zillion paper charts printed and they are already there
3. someone in the local gov't's friend/family/whatever would lose their job if all of those paper charts didn't have to be scanned
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It's always a money issue. Has nothing to do with adaptation. Paper charts are 99% of the time less efficient than an EMR, and everyone is aware of it. The LA County health system is massive, and from what I understand, the money just isn't available to upgrade past paper yet. As someone pointed out, county systems often lack money, and what money can be scrounged up is spent on things people would rather have. I can appreciate the ease of an EMR, but I don't think that eliminating places to train based upon use of a paper charting system is a very good way to weed programs out.
D
deleted109597
For looking up the old record, you're absolutely correct.
However, for writing a new one, T sheets are generally quicker than most EMRs, and I haven't found one that works better so far, having worked with Wellsoft, Epic, and Meditech.
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I had a really long response, but secondary to spontaneous site maintenance, I lost it. So here's the short version from my limited experiences:
T-sheets: fast for documenting, long time wasted finding the pt's charts for everything, horrible medico-legally, never enough room / time to write everything you should
Wellsoft: love it. Similar to t-sheets for the template but much better to write HPI, pt progress/updates, and medical decision making. Much better medico-legally - we use voice things to talk into the chart which speeds up the progress. Worst problem is when you lose your voice. I found typing things in the ED I do less documenting because of time.
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Cook County switched to EMR in 4/2011, using FirstNet/Cerner. Some patients have prior ED visit notes from the paper system uploaded, i don't know if they've uploaded all of them though...but it is possible to review prior ED visits. Also, we have access to all the electronic notes from inpatient and outpatient medicine, which has been in place since the new hospital opened up I believe. Also more and more of the Cook County Health System seems to be switching over to the EMR and we have access to all their notes too.
