Saturday, April 3, 2010

Going Full Blown EHR Sorta Sucks

After such a title, please know this up front: I love my EMR…most moments of most days.

What I don’t love, not in the least little bit, is changing how I go about dealing with everything related to patient care information capture, manipulation, and sharing. Converting from a tried and true workflow that has allowed me to provide the best care I’m capable of providing (at least, that’s as true as it could be with paper-based data) to processes that feel foreign and kludgy and downright odd sorta… well… sucks!

After spending our formative years learning how to navigate paper and penmanship (deterioration of the later aside), we are now challenged by the transformation to an almost entirely different way to manipulate our information. Further, it isn’t just how the data goes from brain to storage; it’s how that info is accessed, viewed, and managed.

Sure, we (my staff and I) have all been using computers for a while now (from 3 to 40+ years,) but none of us were even remotely prepared for the overwhelming shift in processes and the enormous learning curves we encounter by going medically electronic.

I’ve tried to think of a comparable or analogous change. Changing how we do banking, changing how we access news and gossip, changing how we buy and window shop, changing how we research and do schoolwork, changing from viewing three television channels which closed shop at 2:00 A.M.to a bazillion — all of these were virtually effortless. We all do all of these things now, even though we weren’t “skillsetted” with them in our youths. None of them seemed like a mountainous climb.

But, changing from free flow data capture, be it for SOAP notes or lab orders, via the familiar pen and paper format to the seemingly simple point-and-click tech of a PC has been, without question, the greatest challenge of my life. (OK, aside from raising kids, maintaining a healthy marriage, dealing with cluster headaches, and remembering to put the toilet seat down, that is.)

It isn’t just how the data goes from head to storage — it’s how everything gets accessed, viewed, shared, and integrated into pre-existing mental categories. My synapses have been strained beyond their original design constraints trying to establish new neural connections and pathways for this completely queer new work style.

I hope I’m not alone when I admit to being exhausted by “change management.” Back in the “pre-EHR days,” it was really easy (relatively speaking) to go to work, see patients, and deliver myself home at the end of the day with some smidgen of energy reserve. Nowadays, my serotonin and dopamine stockpiles are so depleted that I barely have enough left over for fĂȘting my youngest son’s latest fourth grade feat or catching a chuckle from my wife’s current chef-challenged concoction.

Why put myself and my longsuffering staff through all this? Simple. Because, as I said up front, most moments of most days, I absolutely love my EHR. I am daily astounded by the new capabilities I am gaining to deal with data. The upside usually outweighs the downside. It is, without question, worth it.

However, that doesn’t mean this transition time doesn’t sorta suck. It does, big time.

From the trenches…


“Always be yourself…unless you suck.” - Joss Whedon

First posted on HIStalkPractice.com, March 31, 2010.

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