If you are unfamiliar with the term, the Luddites in England of the early nineteenth century disapproved of the industrial revolution, and wrecked factories by industrial sabotage to protest the replacement of their skilled labor jobs by machinery. Their attempted social de-evolution led Luddites to execution or transportation to Australia. Many today, wishing for return to a quieter, calmer, lower existence, believe that the Luddites may have been on to something.
If you lean toward the neo-Luddite, you might elect to avoid EMR like the plague (In fact, you will not find much dispute in medicine that the plague is in fact a good thing to avoid, so perhaps the analogy is not a great one). We all know people who do not have an email address (gasp!), Which in our era is like not being sure how to use a telephone or play a CD (Although come to think of it, this analogy may have holes as well . I'm not always certain how to use the multifunctional “Swiss-Army-Knifish” cell phone that I own … really, why would I wish to shoot home movies on my phone, or read books on that itsy bitsy screen. And today, I accidently shut the phone off while speaking the brush of an earring … oftentimes several times per conversation if I'm particularly bejeweled in a particularly stylish pair.). Oh my gosh, maybe I'm a neo-Luddite too!
My brother Robert is what I call a selective Luddite. Although he works as a high level computer programmer for a multinational corporation, he carries a pocket watch, and does not even own a cell phone. He is confused by conversations about whether he can join your 'circle', as he limits his television viewing as well. Given the frequent interruptions of my life by my own personal torment device AKA cell phone, I can see his valid Ludditian point.
Regardless of my status as a neo-Luddite wannabe, I am an EMR cheerleader. I designed my own one person practice to be enhanced by use of new EMR technology- a technology which allows the practice to more easily serve our patients, rather than wrench them away. In an office setting, when a patient calls, we all may have access to their chart at the touch of a / several buttons. Immediate, real time care can be given, rather than the 'take a message and someone may call you back … eventually'. In addition to better customer service and better patient care, our practice costs a lot less- less transcription, less chart pulling by staff, and less postage as most correspondence is sent out by fax. Referring physicians like our faxed reports as their speed in getting results whilst a patient waits in their office is near-instantaneous … and they need only request records in the rare instance that records are not faxed out on the very day that the patient is seen.
Beyond the office management and customer service logistics, we enjoy lifestyle logistics. I can check my lab results and write notes where I am right now, sitting on my back porch with a wireless connection. My staff can sign on from home to provide clinical support. My nurse Deb oftentimes takes patient information sheets home to do data entry in the evening or late at night for our direct access colonoscopy patients; she can access the office via secure server and a virtual desktop. I myself have kept in touch from the Incan temples of Peruto my rural lakeside retreat. My EMR buys my staff time and flexibility.
My freedom, in a bundle that weighs less than five pounds.
But what about endoscopy? Is the power of EMR being harnessed wisely in your suite? Perhaps not.
From the doctor point of view in your unit, EMR is groovy. We use software like EndoSoft, allowing us to quickly generate a report with full color photos based on our own personalized templates, and then send that report by fax to our referring docs and hand a spare copy to patients. Quick gratification. Great customer service. Exclude the middleman / woman of medical records and transcription. What's not to love? Oh, and our hospital loves our endoEMR too, estimating that we might be saving as much as $ 100,000 per year in transcription costs (of course, the system costs money, but once it's up and running, the payback period is reliably short).
But then I look at my circulating nurses work station and roll my eyes. IMHO, endoscopy nurses and EMR have not properly interfaced. Anna's cart features a computer screen and keyboard for the surgical scheduling computer, another computer screen for the hospital system (to enter pathology history data), and yet another screen of texts for the monitor, the vital signs displayed then inserted manually into papers wedged on the remaining sliver of space remaining on top of the desk. Yesh. Adding another non interfacing computer does not sentence a useful patient care tool; the problem in our suite seems to be a commitment by the Hospital Information Systems (HIS) people on making the interface of these multiple machines work. Just looking at the multiple systems, I'm tingling with an industrial sabotage Luddite-ish urge.
My question: Do your nurseries, particularly the specialist nurses like those in GI, have a seat at your hospital's HIS conference table when new technology is chosen and implemented? I can not imagine it is so, with the lack of coherence I see on that cart across the stretcher from me every day.
What to do? Have your endoscopy unit manager contact HIS and hospital administration, and make sure that interested and tech savvy nurses are appointed to purchase and implementation committees for new software installations at your hospital or endoscopy center. Or appoint a techno savvy endo nurse to interface with HIS geeks to work on the endo system you already have, until a smooth and seamless interface between the multiple monitors is realized.
EMR holds a great deal of promise in medicine. The promise to allow us more quality time with our patients, less redundant labor, better communication. But only you can dare to embrace, and interface with, your technology. It's either that or face transport as a Luddite.