An Epic Adventure: Introduction
I am about to be forced to use the EMR abomination know as “Epic” in order to continue to perform surgery at a particular institution, one where I spend ~10% of my clinical time. My work there is very profitable for the institution; I am not paid by the institution. At present my administrative load is 2X what it was 5 years ago, but the majority is borne by my staff. Once I am required to use their EHR my administrative load will increase at least 20X and I will bear all of it.
Why? My forms are standardized and fulfilling my part of the administrative load presently requires approximately 8 signatures for each case. 8 swipes with a pen on 8 pages layed out before me and marked “sign here”. Time = 0:10/case. Soon I will have to sign into the system for each case and move through a series of ~5 steps to reach the point where I will perform the digital version of my sweeping pen. Time, I am told by colleagues using the system to achieve this, = ~4:00/case. Let’s be generous and assume that they can’t possibly be correct, that it can’t possibly take 4:00 to do digitally what I now do with a pen (Heaven help if I have to enter pre- and post-op orders w/out standard forms!), and that it’s only 2:00. A typical OR day includes 20+ patients. 40 minutes added minimum. Did I mention that I have to do it TWICE because you can’t sign an op note right after surgery?
Lest you think this 52 yo doc is a Luddite and has avoided any and all such technology let me assure you that quite the opposite is the case. We have had an extremely efficient EMR in our office for 7 years; our management and scheduling has been done by computer for 16. My home is littered with Apple products. I’m a buyer of tech WHEN IT MAKES SENSE.
Unfortunately, it appears that I’m about to be forced to be a buyer of this “meaningless use” very soon. I thought I’d share the experience with you here. I’ll keep a log under “The Epic Adventure” and I’ll record not only my experiences but also the time I will be forced to “invest” in learning how to use the system and the time it takes me to comply with its requirements.
It promises to be quite a ride, albeit a rather slow one
Tags: ehr, emr, eyecare, healthcare, healthcare reform, meaningful use, medicare
This entry was posted on Wednesday, December 21st, 2011 at 1:58 pm and is filed under Health Care, Healthcare Economics. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.
December 21st, 2011 at 3:19 pm
Another horrible thing about Epic is that they are using a proprietary database rather than something that has been around forever, like SQL. There are thousands of books on SQL and many, many systems that can easily integrate with it. Also the number of IT workers in SQL is large, so they are readily available and don’t cost as much as a specialty guy. Using their own custom database does nothing for the end user except increase the overall costs, which are already enormous. It does benefit Epic though, you have to go through them and them alone. This should almost be illegal in the health field.
December 21st, 2011 at 4:30 pm
Didn’t know that, Aaron. Doesn’t make me feel any better!
December 22nd, 2011 at 3:36 am
Another horrible thing about Epic is that they are using a proprietary database rather than something that has been around forever, like SQL. There are thousands of books on SQL and many, many systems that can easily integrate with it. Also the number of IT workers in SQL is large, so they are readily available and don’t cost as much as a specialty guy. Using their own custom database does nothing for the end user except increase the overall costs, which are already enormous. It does benefit Epic though, you have to go through them and them alone. This should almost be illegal in the health field.
+1