Top Issues with Your EMR

[InformaticsRN.MA]

Hello,

As an RN who recently moved to the IT world, I will be spending the next few years helping to improve the electronic documentation at my hospital. I was wondering if anyone could share your experiences, both positive and negative, with computerized documentation.

-If there was one specific part of your EMR that you could change, what is it, and how would you change it (realistically)?

-Is your employer educating staff about Meaningful Use?

-What system do you have (e.g. Meditech, Epic, Cerner, etc)?

-What % of your day are you spending on the computer?

-How do you think your patients feel about the growing role of computers in healthcare?

Thanks for your feedback:-)

[akomismo]

EPIC is the best system right now which almost majority of big hospital in US using it. Is simple u just need to select / click what u need 😊

[tokmom, BSN, RN]

I like how I can actually read notes and not deal with doctor scribble. I hate downtime, slowness, and having to chart the same thing 50,942 times on one patient. We have Meditech.

[silson4]

Efficient system.

[classicdame, MSN, EdD]

We use HMS. I know the Informatics team and know that they have input on various modules. Nurses complain to me (Educator) they spend more time "nursing" the computer than the patient. To give/not give flu vaccine requires TWENTY steps. Thinking is that documentation is more impt than caring for patient. Who has time for that? Do we really want nurses to focus on something other than excellent care?

[akomismo]

We use HMS. I know the Informatics team and know that they have input on various modules. Nurses complain to me (Educator) they spend more time "nursing" the computer than the patient. To give/not give flu vaccine requires TWENTY steps. Thinking is that documentation is more impt than caring for patient. Who has time for that? Do we really want nurses to focus on something other than excellent care?

What 20 steps for flu vaccine shot? That question can only answer by yes or no in epic chart and only cause u a second.

[Anonymous865]

I'm not a nurse, so I'm addressing only your question about how patients feel about the growing role of computers in healthcare.

I worked for many years for one of the EMR companies mentioned in the above comments. I really believed that an EMR would help improve the quality of care provided. Having experienced EMRs as a patient, I confess that I WAS WRONG.

My PCP computerized several years ago, and I HATE it. When my PCP was using paper records, she could look at me, make notes, and really listen to me all at the same time. Now she rarely looks at me. She has to concentrate so much on the computer screens that she misses at least half of what I say.

After a recent hospitilization, I got a copy of my hospital records. It was shocked by how many mistakes there were in my records.

It seems I have had gastric bypass surgery (I haven't) and also take a drug to help me gain weight (I don't). I was also surprised to learn I've had a hip replacement. I also discovered according to my records I was 20+ years older than I thought (about the same age as my mom!) and was hospitalized for CHF, ARF, malnutrition, pneumonia, and ovarian cancer. That's just a few of the errors I discovered.

What was most interesting was how one person would document something incorrectly and then each person who cared for me after that documented my progress for that wrong diagnosis.

Different sections of the EMR had conflicting information. How can my I/Os as recorded in I/Os differ drastically from the I/Os recorded in ADLs and from I/Os that I was charged for (e.g. I was charged for 64L more normal saline than the record shows I was given over a 5 day period.) How can providers make treatment decisions when the data isn't even close to being correct?

It seems to me, a computerized record just makes it easier to propogate errors. The errors in my hospital records were forwarded to my physicians and added to their records. Since hospitals, physicians, pharmacies, and insurance companies are all computerized and share information, I doubt that I will ever get my records correct.

The only positive I saw was scanning meds and my wrist band. The computer checked the 5 rights. Of course they somehow didn't input as drug allergies the 2 drugs I am allergic to, so even that was not a huge positive.

Before you blame the hospital, I'll tell you I was at an academic/teaching, magnet, top 100 hospital.

After my experience I started querying family and friends on their opinion of EMRs from the patient's perspective. Every single person hates them and many of them are in the computer industry!