Restricting Nurse Access to Electronic Records

[LilacRN]

I am looking for information on the restriciton of access to electronic medical records for nursing. Our hospital is in the process of implementing the Meditech system. Right now the only part the nurses use is OE (Order Entry) and the EMR (Electronic Medical Record). However, we are building the PCS (Patient Care System) which is nursing documentation.

Currently all nurses are "restricted by location". Meaning that they can only view the medical records of the patients assigned to the unit they are on. When they are signed on to a PC, the PC has already been assigned a location so It knows where the nurse is.

This has caused some problems, because if you are getting a transfer, you cannot go into the record until that patient is assigned to your unit. So you can't reveiw anything before they get there (even if you have some downtime). Also, for outpatients that do not get assigned a room number, no nurse has access to any of the records. We do have a function that allows us to open up some temporary access, but in reality it does not get used as it should.

Is anyone working with the Meditech system that is also "Restricted by location" and does it affect your ability to obtain information about patients.

Another issue is doing closed chart audits, managers handling complaints, reviewing staff documentation etc.....

Any help would be greatly appreciated.

[rninformatics, DNP, RN]

Contact your vendor rep and have him/her connect you with the MUSE group - the Meditech Users Group. This group can give you valuable input related to how other facilities (who also use the Meditech product) went about addressing this issue. Dont reinvent the wheel talk to those who have already "been there, done that" .

Good Luck!

I am looking for information on the restriciton of access to electronic medical records for nursing. Our hospital is in the process of implementing the Meditech system. Right now the only part the nurses use is OE (Order Entry) and the EMR (Electronic Medical Record). However, we are building the PCS (Patient Care System) which is nursing documentation.

Currently all nurses are "restricted by location". Meaning that they can only view the medical records of the patients assigned to the unit they are on. When they are signed on to a PC, the PC has already been assigned a location so It knows where the nurse is.

This has caused some problems, because if you are getting a transfer, you cannot go into the record until that patient is assigned to your unit. So you can't reveiw anything before they get there (even if you have some downtime). Also, for outpatients that do not get assigned a room number, no nurse has access to any of the records. We do have a function that allows us to open up some temporary access, but in reality it does not get used as it should.

Is anyone working with the Meditech system that is also "Restricted by location" and does it affect your ability to obtain information about patients.

Another issue is doing closed chart audits, managers handling complaints, reviewing staff documentation etc.....

Any help would be greatly appreciated.

[hollyster]

The ER and CCU/PCU nurses had complete access but the floor nurses were restricted to only their current pt.s.

Good luck with Meditech. In my opinion it is the worst software a hospital can have. I constantly goes down, they still have not worked out the bugs in the system and it is very user unfriendly.

[rninformatics, DNP, RN]

The reason(s) that any given system goes "down" or has unexpected, frequent or prolonged down-times are often not so much system specific as network or configuration specific - meaning frequently the issues/problems are NOT due to the individual system but often due to network inadequacies, resource insufficiencies and or set up issues related the hospital's network. There is usually more than one system or individual thing that causes an unexpected or prolonged downtime. When you wrote "the system is unfriendly"..... Can you be more specific?....... and Have you proactively taken these specifics to the powers that be at your organization?

The ER and CCU/PCU nurses had complete access but the floor nurses were restricted to only their current pt.s.

Good luck with Meditech. In my opinion it is the worst software a hospital can have. I constantly goes down, they still have not worked out the bugs in the system and it is very user unfriendly.

[hollyster]

When you wrote "the system is unfriendly"..... Can you be more specific?....... and Have you proactively taken these specifics to the powers that be at your organization?

I was on the original meditech superuser group and helped to implement the system to our hospital, we were all aware of the problems. I was very hopeful when we first started. We notified corporate was notified on a weekly basis and we had great IT but three years later the same problems exsist and so do the complaints. It is inefficent. But that is just the opinion of the two different teams from two cities.

[Mulan]

I hate MediTech!

[LilacRN]

I hate MediTech!

Thanks for all the advice. I have just recently found out about MUSE.

I am curious for specifics as to why you hate Meditech so much. Is it soley because the system goes down or is there a problem with the documentation flow or is it an access issue ??? Is it something that I could work on here so the nurses here don't hate it so much?

It is definitely not a perfect system. It was actually #3 on the top 3 list that the committee in our hospital chose. I had just started to work at this facility when that decision was made. However; the #1 choice went bankrupt, and the # 2 choice priced themselves out of range for us so they purchased #3 which was Meditech. I don't even know the names of the #1 & 2 choices.

This whole process though is fascinating. It is such a change from doing the patient care aspect of nursing. I started here as a nursing supervisor and working prn in the ER. Then I took a Nurse Manager position, I still ended up working on my unit a lot because we were so short staffed. Now my job is totally Meditech related.

Thanks again. I hope you can find a way to make your documentation system work better for you.

[1010rn]

I have been working in a hosp for 4 years with Meditech. It is very nursing UNfriendly. It's hard to believe that big hospital companies are still committed to a DOS system in the year 2006. When will they let this dinosaur die? I understand that it is very friendly when it come to generating reports and tracking numbers. Something the suits in finance/billing/management want. They don't care how difficult a system it is for the nurse and caregiver to navigate. In a time with such nursing shortages, you would think they want us as efficient as possible. It will never happen with this system. The way IT configures the system, nurses from unit to unit can't access other pt's. You may ask your IT administrator it they can change it, with permission from your manager. I encourage all nurses to let your frustrations be known regarding MEDITECH

I am also curious about hospitals using the E-MAR system. The medication documentation part of MEDITECH. Can you really believe how long it takes to give a patient their medication?? From faxing the order to rx, awaiting them to prepare and register in, acknowledge it the the sytem, scan it , scan the pt and then give the med. I am in favor of safety mechanism in order to prevent med errors. BUT, let's get a system that facilitates accuracey and efficiency. From the nurse's I work with E-MAR sucks.

[Choircat]

We are in the training process with Meditech. Our hospital was bought out by a hopital system that uses this system. We we using the Siemens system and that was very user friendly with many safety checks. I am finding it hard to believe how un user friendly meditech is and how little safety checks are in place in the EMAR system

[Sleepy 7]

1) No obvious alert if wrong drug etc is scanned w/ EMAR. MAC does

2) Meditech is slow

3) Meditech : does not show all information at once like Careview/Siemens does.

4) Meditech is not infinitely expandable - careview is .

5) Meditech duplicates everything -one has to weed out the entries listed to see where to chart- NO continuity of information.

6) User interface is SLOw SLOW SLOW No Mouse

7) Iand O's ,IV's must be entered one by one everytime , imagine 8 or 10 drips in ICU this will self distruct quickly.Don't even start on the titration.

8) due to # 7 information , especially on CABG pt's will be incorrect.

I could go on for days about how bad Meditech is , but since Our new TN parent seems to be only interested in profit ......

And I actually like computers

Oh did I mention if we look at a pt's records that is coming to us from another floor before they are "admitted" to us ie. enroute down the hall we will be fired for a HIPAA violation.

[captaincoffee]

I actually like the Meditech system. Oh, I was very hesitant at first and fought using it all the way. But, with time I find it very easy to use and even helpfull with obtaining old records. We are not restriction to pt access from unit to unit, monitored yes. I actually work Er, CCU and occasionally MSP and can access all pts withut a problem. Oh the system may go down on a reare occasion but it's a computer/server, and to be expected!

[Sleepy 7]

Ours is restricted with threat of firing.

Either you haven't done hearts

or used Careview

or your system is newer than ours , which may be the case The travelers we have , have told us that this is the oldest system they have ever seen , they love our careview and a few have called their managers back to tell them they have never seen a better system.

But Lifepoint bought us so we can't expect much.

Thanks for the reply.