Sunday, June 20, 2010

Extra Hour in the Sun

As a new intern at a well-endowed medical institution, I was disappointed despite the flurry of excitement that comes with orientation. I was disappointed despite the brand new privilege to save lives and relieve human sufferings. And the disappointment was made clear to me over the past two days.

What has happened in the past two days? As I will be working at two separate hospitals, for the past two days I have sat through training for at least 5 different EMR systems, none of which are similar or produced by the same company, all of which are designed to do the exact same things as hundreds of other EMR systems used in other parts of the country.

What really drove this home, as I zoned out during training for the 4th EMR system of the day, was the fact that in the mix, I didn't receive access for one of the EMR systems. The technician at the training center instructed me to call help desk when I got home. At home on the phone with the help desk specialist, I was told that the issue unfortunately could not be solved on the phone and I would have to return to the training center. As I hung up the phone, I thought how nice it would have been if I had found this out 15 minutes ago when I was still at the training center.

But I wasn't told that stopping by the help desk was an option. I wasn't informed that the help desk was in the same building as the training center. I didn't know that there was a possibility that this issue could not be solved on the phone.

Could this whole ordeal have been foreseen? Could it even be possible that I'm not the first person who fell through this trap? Very likely. But this is only one of the possible failings in our highly fragmented, variable medical system. With 5 different EMR systems in only two hospitals, how could a human being possibly plan for all the possible shortcomings these non-uniform processes create?

It's not a matter of inconvenience that new providers have to learn 5 new computer systems in two days - it is a matter of patient safety. I continue to be amazed that despite all our advances, we as a country have not reconciled our differences and agreed on a uniform EMR across most, if not all, medical institutions. The benefits are many, including the ability to consolidate fragmented/repetitive medical information, better coordinate care and reduce possible mishaps created by each separate system. The waste that goes into reinventing the wheel, retraining medical professionals, troubleshooting hundreds of different EMR systems nationwide is likely enormous.

I believe that amidst the effort to reform health care, the time is ripe for us as a country to put our self-interests aside and work together so that future medical professionals and patients do not have to settle for this substandard, fragmented medical system. But until then, I am walking back to the training center to tell Jim, my computer trainer, what had happened to me so that future interns can have an extra hour in the sun instead of spending time at a computer training center.

1 comment:

  1. I agree from personal experience just learning one system at the DOD AHLTA system for the US Army. There are two systems, one for outpatient and one for inpatient. The ER does not use EMR and some hospitals have different systems. Many practicing physicians use three or four hospitals as well. Add to that the need to change your password every 60 to 90 days. Plan to add 10 or more minutes/day logging in to these EMRs. You are not alone, and thank you for publishing this on KevinMD