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But the doctors almost always were taking notes anyway. My step father (A doctor) fought a losing battle against electronic records because he had _decades_ of

But the doctors almost always were taking notes anyway. My step father (A doctor) fought a losing battle against electronic records because he had _decades_ of paper records stored in the "records" room of his office. That was largely the responsibility of the front desk to pull the patients records and have them ready for him to read/check before seeing the patient. Then clean them up and refile them. Long term patients had pages and pages of hand written notes, prescription histories, etc. So a part of the job has always been the record keeping, OTOH, as one of the other users mentioned, I've seen enough Dr's using their computer records systems to know that software is mostly garbage. The Dr's spend 2-4x the time dealing with the shitty UI as actually typing in the notes now. (In the end he basically retired instead of convert to electronic records).

covidiot5 4y ago
They’re taking notes with cheap pencils and paper! We should sell them an complex, messy to build, fleet of machines! It’s like cutting off a head when stitching a cut on the leg was the problem.
toss1 4y ago
Sounds about right For those that seemed to transfer successfully, I noted that at Mayo Clinic, the doctors use live dictation software and dictate at least some of their notes into the system while the patient is present near the end. This immediate review sometimes brings up a few new questions (from either Dr or patient), and a bit more notetaking. So, it looks like a very efficient system. They also have no apparent shortage of staff organizing things. That said, I doubt every medical organization and office has the same quality setup as a top world-class institution. At some level of degradation, the system becomes more of a hindrance than a help, and that point is likely fairly near the top levels (so most of it is a hindrance).
- bombcar 4y ago
  Dictating while the patient is there is brilliant, because it double-checks both the doctor and the patient's understanding of what happened.
  - toss1 4y ago
    Yes, I thought so too Edit: Also, I was generally quite impressed with their notes
  - dzhiurgis 4y ago
    Forms give you validation errors or warnings instantly tho
    - toss1 4y ago
      Huh? What form would give validation error or warning that a note the Dr is making either raises a new question by the patient or is in conflict with something the patient knows? (& yes, from what I could see, there were also fields for patient data, date, etc, that are presumably validation-checked)
analog31 4y ago
I've never seen the same doctor twice in a row. What I've noticed is that EMR has greatly reduced the amounts of screw-ups or delays caused by not having the right information at hand, or having to repeat tests. Also, since there's now a terminal in every examining room, I can see what amount of effort is required to use the EMR tool (Epic in the case of my provider), and it doesn't seem all that onerous. I can guesstimate the additional amount of time that they spend outside of clinic hours, completing their records for the day, and again, it doesn't seem onerous. For a few years I had to fill out a lengthy medical history form, every time I visited a clinic, but that's pretty much gone today. My primary care doctor just retired, and her replacement took up the baton without skipping a beat. She can also easily delegate to her physician's assistant or nurse practitioner, so they can all work as a team, with instant access to the same information. Now I have noticed something interesting. The urgent and primary care clinics all have a terminal in every examining room, and the clinicians perform their examinations while seated at the terminal, except when they actually have to poke around. That's where it seems quite efficient. In the hospital wards, they still don't have a terminal in each room, meaning that each clinician has to look things up at centralized terminals, remember them (or not), and has no access to information. If they need some information, they will come back with it, next time their make their rounds, which might be the next day. And they screw up. My dad had an episode that took him through an ER, to a regular hospital bed for a few days, then to a rehab ward. I had all of his records at my fingertips thanks to MyChart on my laptop. The doctors and nurses were lost, they completely overlooked the documented diagnosis that was at the root of is condition, and didn't believe me about it. Some of the nurses in the hospitals now have a terminal on a wheeled cart, that they bring on their rounds. What I'm guessing is that in the days of handwritten records, the doctors were mostly winging it.

covidiot5 4y ago

They’re taking notes with cheap pencils and paper! We should sell them an complex, messy to build, fleet of machines! It’s like cutting off a head when stitching a cut on the leg was the problem.

toss1 4y ago

Sounds about right For those that seemed to transfer successfully, I noted that at Mayo Clinic, the doctors use live dictation software and dictate at least some of their notes into the system while the patient is present near the end. This immediate review sometimes brings up a few new questions (from either Dr or patient), and a bit more notetaking. So, it looks like a very efficient system. They also have no apparent shortage of staff organizing things. That said, I doubt every medical organization and office has the same quality setup as a top world-class institution. At some level of degradation, the system becomes more of a hindrance than a help, and that point is likely fairly near the top levels (so most of it is a hindrance).

bombcar 4y ago
Dictating while the patient is there is brilliant, because it double-checks both the doctor and the patient's understanding of what happened.
- toss1 4y ago
  Yes, I thought so too Edit: Also, I was generally quite impressed with their notes
- dzhiurgis 4y ago
  Forms give you validation errors or warnings instantly tho
  - toss1 4y ago
    Huh? What form would give validation error or warning that a note the Dr is making either raises a new question by the patient or is in conflict with something the patient knows? (& yes, from what I could see, there were also fields for patient data, date, etc, that are presumably validation-checked)

analog31 4y ago

I've never seen the same doctor twice in a row. What I've noticed is that EMR has greatly reduced the amounts of screw-ups or delays caused by not having the right information at hand, or having to repeat tests. Also, since there's now a terminal in every examining room, I can see what amount of effort is required to use the EMR tool (Epic in the case of my provider), and it doesn't seem all that onerous. I can guesstimate the additional amount of time that they spend outside of clinic hours, completing their records for the day, and again, it doesn't seem onerous. For a few years I had to fill out a lengthy medical history form, every time I visited a clinic, but that's pretty much gone today. My primary care doctor just retired, and her replacement took up the baton without skipping a beat. She can also easily delegate to her physician's assistant or nurse practitioner, so they can all work as a team, with instant access to the same information. Now I have noticed something interesting. The urgent and primary care clinics all have a terminal in every examining room, and the clinicians perform their examinations while seated at the terminal, except when they actually have to poke around. That's where it seems quite efficient. In the hospital wards, they still don't have a terminal in each room, meaning that each clinician has to look things up at centralized terminals, remember them (or not), and has no access to information. If they need some information, they will come back with it, next time their make their rounds, which might be the next day. And they screw up. My dad had an episode that took him through an ER, to a regular hospital bed for a few days, then to a rehab ward. I had all of his records at my fingertips thanks to MyChart on my laptop. The doctors and nurses were lost, they completely overlooked the documented diagnosis that was at the root of is condition, and didn't believe me about it. Some of the nurses in the hospitals now have a terminal on a wheeled cart, that they bring on their rounds. What I'm guessing is that in the days of handwritten records, the doctors were mostly winging it.