With an overtly elderly medical population, and the availability of advanced technologies, patients have become so complex that the majority of a physician’s time is spent gathering information from the past and compiling it into a meaningful way to relate it to the chief complaint. The precious time spent sifting through medical charts from a seemingly infinite universe of discharge summaries all with their own distinct opinions regarding the patient’s state is absolutely inefficient. Most physicians, including emergency doctors, spend a majority of their day as Information Gatherers.
We have too much content.
There are just too many notes, and too much repeating information in EMR. There are too many different perspectives from too many different types of health care providers including attendings, fellows, residents, medical students, nurses, nutritionists, respiratory therapists, and physical therapists.
In an article called “sloppy and paste,” a term used to describe how physicians will often copy and paste the bulk of their daily progress notes, the author hauntingly states that several errors result from this behavior. For example, referring to a case study in AHRQ WebM&M, an intern had written for heparin for venous thromboembolism prophlyaxis for a very high risk chemotherapy patient, but the patient was never given the heparin presumably because the order was never actually performed, and the patient returned two days later with a pulmonary embolism. The other residents and attendings had signed off on the note several days in a row in fact. That is an example of important facts being lost in a whirlwind of notes. At times it is reminiscent of the game "Telephone" where the final statement becomes altered and reframed in a way that bears little resemblance to the original statement.
The time freed can be used by all physicians to better diagnose and treat patients, assist nursing staff, speak in detail to patients about their conditions, teach medical students at the bedside, or even have a well-deserved coffee break with colleagues.
As emergency physicians, we are likely bothered by endless sermons about patients, and prefer limiting patient discussions to pertinent bites of information.
Do you agree?
We have too much content.
There are just too many notes, and too much repeating information in EMR. There are too many different perspectives from too many different types of health care providers including attendings, fellows, residents, medical students, nurses, nutritionists, respiratory therapists, and physical therapists.
In an article called “sloppy and paste,” a term used to describe how physicians will often copy and paste the bulk of their daily progress notes, the author hauntingly states that several errors result from this behavior. For example, referring to a case study in AHRQ WebM&M, an intern had written for heparin for venous thromboembolism prophlyaxis for a very high risk chemotherapy patient, but the patient was never given the heparin presumably because the order was never actually performed, and the patient returned two days later with a pulmonary embolism. The other residents and attendings had signed off on the note several days in a row in fact. That is an example of important facts being lost in a whirlwind of notes. At times it is reminiscent of the game "Telephone" where the final statement becomes altered and reframed in a way that bears little resemblance to the original statement.
The time freed can be used by all physicians to better diagnose and treat patients, assist nursing staff, speak in detail to patients about their conditions, teach medical students at the bedside, or even have a well-deserved coffee break with colleagues.
As emergency physicians, we are likely bothered by endless sermons about patients, and prefer limiting patient discussions to pertinent bites of information.
Do you agree?
