MARS: electronic or paper?

Specialties Geriatric

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With healthcare reform - aren't paper MARS supposed to be banished and all health care facilities will have to start using electronic MARs and charting? This is what I have heard - does anyone know details? I know some LTCs are using computers but it sounds like a lot of them are still using paper. What system does your facility use and what do you think of it?

We currently do paper MARs/TARs (but are slooooowly in the process of transitioning), but not handwritten - all the pages are computer-generated. There's still a lot of room for human error if the new order isn't printed our, or if an order is d/c'd and not noted in the MAR (or someone yellows it out in the MAR but doesn't d/c it in the computer).

We've done computer charting as long as I've been there, and I'm ever so thankful for this. I type much faster than I write!

We have EMAR and ETAR.

My facility uses the Sigmacare program, and I think it is fantastic. It has a simple layout and easy to use functions. Transferring a resident out to the hospital takes me 5 minutes flat with "paperwork". The program has a Patient Intake/Transfer assessment, and just a click of a button you're printing out labs, orders, and transfer summary. The only thing I have to really physically make copies of are the face sheet, immunizations sheet and advanced directives. It calculates our bowel protocol every day. I can schedule a head annual PPDs and History and Physical's for the year. X-rays, EKGs, Ecchos, ect.. are ordered through the program without having to make a phone call. And no more writing out physician order forms, MAR/TAR forms during admissions! I think computer charts are fantastic and I can finally read the orders our holier-than-thou doctor's give!

Specializes in Geriatrics, Dialysis.
I worked in a facility where it was all paper charting and it drove me crazy. Where I am now is a paper MAR system that has been in place 23 years! But we make progress notes on computer. It seems to me that a EMAR would greatly reduce errors in LTC and you could do the med pass faster and easier.

We changed to EMAR/ETAR awhile ago and from personal experience I can tell you it doesn't save time at all. My med pass went faster with the old paper system actually. Mostly because of old orders that continue to show up after the D/C date and orders that show up on days/shifts that they aren't actually ordered...now instead of just circling it and going on I have to stop and write a chart note explaining why the order was not completed. Residents that are out of the building still show up the whole time they are on leave, and discharged/expired people are still there days after they are gone. Not a big deal to code them as out of the building when checking off the EMAR but it does feel like wasted time. We use PCC [Point, Click Care] and there are definitely some problems with order entry. Lab orders do not have an option to add to EMAR so if they are entered as labs they never show up and therefor get missed. We also do not have pharmacy integration yet so there is no time saved on med ordering at all. Hopefully it will get smoother as the kinks continue to be worked out.

Specializes in Geriatrics, Dialysis.
Very disappointing. My facility is pretty responsible compared to the horror stories I've read about LTC here on AN, but a lot of our small issues when it comes to scripts, med changes, change of month MARs, etc. seem like they would all be much better or fixed altogether if an EMAR was in place... sigh

I can say that is one big positive with the change to EMAR/ETAR...no more end of month changeover!!

Specializes in Geriatric/Sub acute/Home Care.

first time I used a computer for charting turned into nightmare at shifts end...computers crashed at the hospital, I sat there for over 2-3 hours trying to remember what I did all day long....had to handwrite everything after that.....technology is very good up to a certain point....then if it crashes You can be screwed.

first time I used a computer for charting turned into nightmare at shifts end...computers crashed at the hospital, I sat there for over 2-3 hours trying to remember what I did all day long....had to handwrite everything after that.....technology is very good up to a certain point....then if it crashes You can be screwed.

Yep, that's my main problem with it, especially as our stuff is on a remote server. If the internet goes down, we're stuck. And it tends to get really slow just in time for evening med pass. Not to mention the frequent 4 hour maintenance downtimes in the middle of the night.

So we'll still need to have and maintain paper MARs, since people still need their meds in a timely manner if the internet is down, right? And not having to do this is one of the main benefits they claim about eMARs.

I really like the idea of electronic everything, but it's a definite serious issue.

Specializes in kids.

The only electronic thing in sight at my facility is an ugly sign out front.....no money for other stuff but we can put cutesy sayings on this monstrosity....live in a relativly rural NE community...stands out like a sore thumb....cannot even begint to hazzard a guess what it cost!

Specializes in LTC, Psych, M/S.

What is ironic about this is I worked with a travel LPN a while back who told me about this small NE facility she worked in and what a great system it was.... All online.

I do not understand why some facilities are making the expenditure to upgrade while others are not - yes they claim to not have $$ but shouldn't there be a standard?

Specializes in Geriatrics, Dialysis.
first time I used a computer for charting turned into nightmare at shifts end...computers crashed at the hospital, I sat there for over 2-3 hours trying to remember what I did all day long....had to handwrite everything after that.....technology is very good up to a certain point....then if it crashes You can be screwed.

Definitely a big EMAR problem. It really sucks when it goes down. Fortunately I almost always work the same unit with the same people as I did a full med pass completely from memory when the system crashed a while ago. Called my DON and told him that was the only way to get the meds done and then hope to God that there were no order changes from the previous night. Pretty scary, but with no access to printing a paper MAR since that is also done from the computer system what else could we do?

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

I work in rehab and my place of employment still uses paper charting and paper MARs. The deadline to make the conversion to the electronic format around here takes place sometime in 2015.

Is this deadline for switching to EMARs a real, confirmed thing, or just a rumor?

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