In 1994 when I was a first year gastroenterology fellow cell phones were expensive and scarce. When I was on call I stayed close to the house and my personal land line phone. If I was paged out at dinner I used a pay phone or begged the hostess to borrow the house phone. So we petitioned our division chief to buy a cell phone for fellow use during weekend call. It ... Continue Reading about Who Owns a Physician’s Smartphone?
There was a time when documentation was an almost inconsequential process. After seeing a patient, the doctor would scratch a note, close the folder, and file it on a shelf until the next visit. Things are different and the medical note has evolved. As it’s evolved, electronic health records (EHR) have brought efficiencies to the medical note while introducing new ... Continue Reading about EHR and Challenges of the Modern Medical Note
Some doctors worry about how EHRs slow them down. I worry about how fast they let us go. Too much dropdown makes documentation too easy. And when it comes to doctors and their EHRs, there’s a fine line between efficient and lazy. Seeing the line is important because when it comes to workflow the drive to completion typically overpowers the obligation to showcase ... Continue Reading about EHRs and the Problem of Efficiency
It used to be that the paper chart was found on the exam room door. Before I entered I’d flip to my last visit, review my impression, check the plan and then enter. Then records went electronic. Now there’s nothing on the door. This has lead to an interesting evolution in my process. Now after a moment of reflection, I just walk in. But that’s not a ... Continue Reading about The Exam Room Entrance
I’ve been thinking about SmartPhrases recently. For the uninformed, the SmartPhrase is a pre-fabricated bit of clinical language used in EHR documentation. We use SmartPhrases to enter frequently used language. It makes life in front of an EHR (EPIC specifically) easier. The SmartPhrase has evolved as the elemental unit of the electronic health record. These ... Continue Reading about The SmartPhrase as Medicine’s Old Technology
I recently had lunch with a young doctor new to our community. The conversation wandered on to how she settled on her new position and the EHR was identified as one of her key selection criteria. She heavily favored positions with institutions running EPIC. Interesting, I thought. Because when I took my first job, the brand of manilla folder used in the patient ... Continue Reading about When Doctors Choose a Job Based on the EHR