Humpty Dumpty Health Records Need To Be Put Back Together

Electronic health records: just one of example of HOW broken our healthcare system is.

Healthcare is BEYOND broken. Let’s just take electronic health records as an example.

In the “old days” we had paper charts and it wasn’t great. Some doctors’ notes were better than others—many had illegible “chicken scratch” for handwriting, and the notes were often too brief to justify the care that was being billed.

BUT…the “old school” nurses’ notes were always EXCELLENT. They gave me as a doctor a “play by play” of what was actually going on with patients during an admission.

BUT…the laboratory and radiology results, when abnormal, had notations to indicate what the doctor’s thought process was.

Continuity of care required faxes going back in between facilities. It wasn’t easy to search for entries or results.

The old system wasn’t perfect, and it was at times cumbersome and there were many opportunities for inadvertent errors

In today’s electronic health record world, though, I think we actually have MORE potential for errors, mistakes, lack of engagement. We have lost the “human” in medicine and the ever-important story-telling components of the patient-physician relationship.

It is by CONNECTING with one another on a human level that we heal and that we change unhealthy behaviors.

Modern day electronic healthcare systems do not communicate with one another and instead of “chicken scratch” one liners we have the OPPOSITE problem—“note bloat.” Ridiculously long notes that say nothing (until a physician gets sued because Care was compromised due to information not being accurate or easily accessible).

Nurses spend more than 40% of their shift clicking endlessly into “yes/no” boxes, or rating pain from 0-10 instead of actually documenting how the patient is FEELING.

In most EHR systems there is no way for physicians and non-physician providers to read nursing notes. The only way to actually find out what went on during a patient’s stay is to track one of them down to find the hand-written sign-off notes that they use to be able to help know which patient is which.

The obscene amount of money charged by oligopolies like Epic, Cerner and other systems are one of the reasons that small independent hospitals are closing by the day.

Humpty Dumpty sat on the wall and has taken a great fall.

We don’t need kings and horses to put medicine back together again.

We need physicians and patients to band together and put some common sense and transparency back into the equation.


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