Former Epic employee here: Your EHR software is still running old subroutines written in the 1970's with an ancient tech stack that hasn't been updated in 50 years. You're right, it's terrible. I think it's criminal to force highly trained medical doctors to spend their time doing data entry work on these systems instead of helping patients. This video was spot on.
My cremain's niche is going to have 'Epic Sucks' on it, no kidding, I'm having the last say! Thanks for the ward clerk shout out too! I was one 25 yrs ago, but went into study coordinting and trying to use Epic for a RCT--ha!
i love this video, i am a nurse and my poor doc is always complaining about it taking 20 clicks to do one thing. I never thought when i went to nursing school that i would spend nearly all my time in front of a computer and only a small amount of time with my patients. I am sure doctors feel the same way, we went to school for our patients not for computers and insurance companies.
I'm a medical transcriptionist transcribing the poorly dictated reports from dictators. Our pay has been cut by 50% since the middle man came between the transcriptionist and the dictator!
That or you actually spend a good amount of time with your patients but have to spend 2+ hours after the shift is over catching up on charting, education and care plans which takes away from time you could spend getting some good sleep so you're at your best to care for your patients. I hope technology will catch up in health care soon so CMS, TJC, et cetera can get the information they are needing without compromising patient care with the patient's care team either giving patients less time due to charting requirements or quality of care if they have to stay after their shifts end solely for charting purposes and aren't able to get good sleep if they work that next day or night.
William R. Reed, MD , PNHP, Chicago. Long time general internal medicine MD.EMR: Epic, Allscripts are truly awful. They were designed only for billing and pharm prescribing. This Video and Rap are 100% accurate.
Love the video.....Ya don't miss your water until your well has run dry........I say that because we MTs (medical transcriptionists) DO matter!!!! We've been screaming this loudly for years but no one wants to hear us! There are sooooo many of us well qualified, experienced MTs who'd LOVE to get back to transcribing so the doctors can be doctors to their patients! Thought cutting out the MTs and bringing aboard EMRs would help save time and money??!!! It's been more costly in the long run. Bring us transcriptionists back - whether its transcribing directly into the EMR or straight transcription!
Absolutely love this video. Just switched to Epic a few weeks ago at my hospital. This video made all our PAs laugh so hard pretty sure I had some stress incontinence.
So true, so true. As a former ED and ICU nurse, and current Director of Clinical Informatics, I have been trying to make usability the focus of EHR unsuccessfully. So glad you are speaking up. How can I help? Not only #LetDoctorsBeDoctors but also #LetNursesBeNurses
bring back a place in the EHR for a narrative note. one that consultants can sing off that they read on rounds like the old progress note. simplify,simplify, simplify- one to two clicks per task
I quit my long-time position I loved, that I thought I'd retire from, over a horrible EHR rollout. When I realized that no one cared about patients anymore, that the only thing which mattered to my bosses was the checkbox, I knew I had to leave before I killed a patient (or them, or myself). I just love this video so much....ever since it came out, I play it all the time - for my colleagues, my medical students, my friends who work in healthcare IT, and pretty much anyone who will listen to my EHR rants! Thank you for being the voice of reason and unity against the madness!
It ends careers before they even start. I was in nursing school for a while, after having been in EMS for about two years. I figured it was time to expand my horizons and move up. I had full intentions on becoming an RN/PHRN (pre-hospital RN), but the whole EHR thing just got to be too much. I felt as though I was doing my patients an incredible disservice by essentially treating a machine, and it was just so WRONG. So back into EMS I went, where I was still (and still am) able to actually treat my patients and even *gasp* converse with them! EMS Charts isn't exactly peaches and cream, but it was, compared to disastrous EHRs. There was no escaping EPIC either, because the only two hospital groups (read: insurance companies) who bought out literally every hospital in my area, all use EPIC. God bless those who are on the EPIC front lines, using that godforsaken interface every day. I commend you all!
I feel ya, but the problem is too many options and no one wants to standardize. Everyone wants their own app and IT has to try to jury rig them all to work together. Keep in mind, Apple "just works" because they clamp down harder than a hemostat on the software. If we had that much power it would work beautifully. I've been clinical and IT, I understand the frustration on both sides. The problem often is that the decisions get made by people who aren't in either camp, beancounters looking for a deal.
amen! when EMR first was being talked about, I was so excited because it was going to streamline communication, force everyone on the care team out of their silos, and create a wonderful dialogue among providers about patient care. Sadly, it has fallen so short of the original idea, it isn't funny. The problem is one that I wrestle with daily - how to realize the promise when this platform is incompatible with that platform, so here we all are - once again - in damn silos.
After a little more time on the IT side I'm finding another problem is that of communication. Each side believes it knows best and there appears to be a failure to appreciate the experience of the other. I'm fortunate to be in a team of Lab IT staff who have all come from the Lab and were then trained into the IT positions. I'm kind of a unique person in that I worked in IT for many years and then trained to be an MLTS when the computer racket no longer gave me joy. But we often get the Lab making instrument purchases without first consulting us to see whether or how well it can be interfaced with the LIS and then they complain when we tell them how expensive it will be to interface or that features they wanted turn out to not be compatible with the LIS. Then on the other side, hospital ITS tries to force software changes on the Lab that don't meet DAP or CAP requirements or require major retooling or other changes to the lab. I don't know if it's so much a matter of neither side wanting to consult us or they just seem to forget that that's the kind of thing we're here for. Nonetheless it creates frustration on both sides and doubles our frustration because it multiplies our workload. If you ever thought the lab was underappreciated, just know it could be worse; you could be Lab IT. The lab doesn't appreciate our lab experience at times and IT thinks we're just clinical staff pretending to be IT.
I am clinical currently, working on getting my HIMT degree. I have been around computers since birth, with my Dad being a white hat since the early 1980s. I have done hospice care since I was 10 - first for my family and now to help other families and their loved ones. So I get the frustration on both sides. I'm all for clamping down harder than a hemostat. I have been thinking about ways to "force" the technology to interface among providers, specialists, and hospitals on differing platforms. The only thing I can think of is to create a hard-lined "intranet" which works on cloud computing with entirely discrete servers from the world wide web. Each platform must display the equivalent of a uniform language to be "understood" by the network. As far as making stuff user friendly, the hardware already exists (iPad, for example). All we need to do is create software which interfaces with the desktop that these poor end-users are trying to drag around their facilities. The only visible answer to me is such an enormous undertaking that nothing short of getting CMS involved would bring it about. I don't think the Lawmakers even see the problems we are facing down here on the ground. What say you? Would this work - or is there another way to help with the information silos? Granted, only each facility can make the determination to actually ASK us, but I think this is a problem which can be solved with decent management sticking up for us - our scope of practice. I'm all for letting doctors and nurses practice to the top of their game, but their management needs to allow us to practice at the top of our game. We are on the same team - management needs to start seeing that fact.
GREAT VIDEO ZDoggMD! I love it!I've worked on a GI/Ortho/Pulm/Pain/Cards... documentation system for many years. From the software side, we try really hard to listen to the clinicians and make the software as smooth and seamless as possible. I like to think we've done a good job and are VERY happy get feedback from clinicians.Of course we have to meet the ever changing quality & legal requirements or people won't/can't buy our software. The challenge always seems to be: make the software flexible enough to support all the medical scenarios but keep it elegant so it doesn't get in the way of the provision of care.We've stuck to certain areas of healthcare that are 'better suited' for standardized documentation and had some luck.To all you providers from an IT guy: I am very sorry for the stress we cause you. The reason I go to work everyday is because of you!
As a doctor living in a bubble I don't get to hear things like this very often that connect on such a deep level that it reminds me of those times during high school when we all thought the songs were written just for us and could listen to them over and over again. I am tempted to get a flat screen and loop his youtube channel in the Care Practice Clinic lobby. I can't believe I missed the fact that Zubin was still doing these the last few years.
We are working on a huge integration of three hospitals to one coherent system. I play this song in the background while waiting for meetings to start. Its gets everyone in a lighter mood and improves the quality of the meeting! Thank you!
ZDogg, One of my patients here in central North Carolina where several platforms were birthed was a software designer. At one of her visits (this was 6-7 years ago) tried to convince me how great EHR was going to be (still on paper back then). In the process, her whole argument was based on the templates making the visit audit-proof for level of service, improving reimbursement. Not one argument for improving actual care. The basic problem is the inability of the government, after mandating EHR by 2014 (now delayed how many times) to not stand up & choose a single base code ALL systems had to be based on so that true communication nationwide could occur. Since that will never happen, thanks for coming up with a clever means of pointing all the deficiencies out. Fortunately, I only need to put up with this BS for another few months before hanging up the stethoscope for good. Good luck to those of you carrying on.
Did you get that from ZDADD MD !!!!!! LOL I just love your Mom and Dad!!!!! They should get a spin off channel! I love your impressions, but they have much better English. This EHR that was cheaply pieced together for NICU in Cerner is awful. The neos cant even see our notes in some places??? We can not see the M.D. notes. The pharmacy is different as well. I just want to pull my hair out. I love babies not square computer screens. Keep on talking about important issues. I have been a NICU nurse for 18 years, and it makes me want to stop what I love. I won't.....
its funny I was watching this again and totally get it - but after seeing the alternative, here in Vietnam.. where EHR Is really very new and only in private hospitals. in public its complete paper files, recopying, chaos with continuity, new files made for each admission, no records tracking.. no history available on readmission. Electronic really does increase safety! A happy medium is best..
Equal access can be achieved by keeping paper records and scanning the entirety of the chart at end of admission. Using an ehr is absolute torture and will prob shorten my career by 50%
Thank you for bringing this issue to people's attention. As a nurse for 20 years, who has worked in IT for almost 10 years, I am very frustrated with how difficult the EHRs continue to be for end users. Daily we have discussions around how the process should dictate the EHR and not the other way around. I work now in data analytics and am a proponent of electronic documentation and interoperability but as long as all the vendors care about is selling their systems and nothing "talks", clinicians will continue to be frustrated. I can do everything on my smartphone with a touchscreen except chart on a patient. Meanwhile the data that we should be using to increase safety and efficiency of patient care exists in a black hole somewhere that no one can share.
Yay! It has been released! Sadly typing doesn't help when you have to click the boxes using mouse - no touch screens except in our pockets! Love how you envision patients seeing the record with us - rotated with a doc who would dictate his notes with the patient at the end of the visit and let them correct any errors!
Internet down - can't pull up patient's charts. Then the patient doesn't know why they're here and neither do we. Internet down - there goes escribe. Prescription pads? What the hell are those? I'm just lucky I'm young enough that I had typing class in school. I see some older folks hired that know what they're doing, but the biggest barrier to them is typing.
You made my week!! I am a primary care doctor who had what was left of my trapezium removed earlier this year....so the wrist reference was appreciated! Great talent...great message!!
Thank you! As a Risk Manager for a physician-owned liability company, you hit the nail on he head! Physicians and other care providers are torn between providing quality care and meeting mandated requirements. Let's hope this catches on and turns into a movement! I'm sharing with my colleagues!
Clinical staff needs to be involved with developing their workflows. Application folks don't magically know what they want. Complaining about it doesn't help - be constructive, be cooperative. Help IT create what you need/want to be successful.
The most important component of Patient Care that is Human Touch has been eliminated by these computers. Healthcare providers have been turned into robots and machines. We must demand for a patient-provider friendly universal EHR that can keep the humanity alive among us.
+ZDoggMD Thanks so much. You ROCK man!!! Keep going. I always make sure to keep on spreading your message to as many ppl as I can and they all love it.
Patients hate EHR too. When I was in the hospital I couldn't get food for a day until they figured how to get my special diet mods in the computer. Instead of looking at patients docs/nurses are forced to look at the screen and enter data. Really makes it hard to have a good relationship with the team.
"If someone say it's epic we say it's epic failure." Brilliant ZDoggMD! You continue to delight, amaze and enlighten! BigLove and Respect from HealthyThinker
I love this video and I love the channel. I'm a 3rd year pre-med student and my Introduction to Biomedical Informatics course is using this as a resource for one of our units. I'm dying over here knowing every student gets to see the brilliance of this man and his team.
Dr. ZDogg. I'm a medical transcriptionist, and we do good work. EHR cut us out of the loop. I know you don't believe it, but MTs are professionals and we catch lots of ERRORS in medical records and flag them so they can be clarified. The old system WORKED - all it needed was to be stored in digital form instead of paper form. They fired most of the U.S. MTs and most work that is still being dictated is being outsourced to India and Pakistan. Sorry, I know they say those MTs speak flawless English, but they don't. I worked in Quality Assurance, and had to do their QA for them. That was after being typed by an overseas MT, being reviewed by a first-line and second-line overseas QA supervisor. Then in final desperation they would send the report back to the U.S. where we would have to correct it. All this for the sake of economy. Where is the economy in having someone type for 2 cents a line when it has to be held up for review and 3 more people have to handle the document, just adding to the cost? Please just go back to dictation and let MTs do what they do best - turn out a quality report with minimal errors. The company where I work makes us maintain a 99.7% accuracy rate, and that's pretty darn high compared to EHR. And you don't even want to get me started on voice recognition. That's a nightmare. I am so happy I found Let Doctors Be Doctors! MTs are behind you. Believe me, we understand, too.
+Pia Nicole Desselle Amen Pia. How do you point and click a detailed history and physical? We medical transcriptionists can get every.single.detail in that record quickly and accurately. Do you know how many medical reports MTs can turn out in a shift? Probably in the time it takes to chart one patient record into the EMR system an MT can complete five-plus reports. I'm a 25-plus-year MT and will happily do ALL of your reports.
+Stacey Gordon There is a solution to the problem. It is 2015 and text mining and machine learning can take ASCII text and write the data to a structured database. Each element in the database can be linked to the exact location in the free text so that text mining errors do not become "facts".
+Hamp Howell These days Voice Recognition is used a lot, and if you speak really clearly there's very not much left for an MT to clear up....but there's always something. Best of both worlds! There'll always be work for a good transcriptionist.
+okierazorbacker Well, then please let the transcription companies know about this miracle, because what you are saying is patently false. I see those reports every day and if I showed you the garbage those VR programs turned out, you wouldn't be so quick to say that. Do the job of an MT who is trying to clean up a report dictated while a lithotriptor is working in the back ground or while the hospital paging system is summoning doctors for a code, and all the alarms are going off at the nurses station where the doctor or nurse is dictating from and see what kind of speaking clearly is going on. It's not. And let's not even talk about ESL dictators, or a doctor who sounds like he graduated from the 5th grade instead of having gone to med school. It's the MT's job to correct his language until he sounds like a professional instead of someone who doesn't give a f%$@. Let me guess, you're not an MT, you're a programmer who THINKS VR works.
@ZDoggmd, I just found you a short while ago and I have to say you are a breath of fresh air, been an NICU RN for 28 yrs and the way healthcare has changed makes one wonder why anyone continues to work in this field. Thanks for the humor that we once had and "the man" and "politically correctness" has taken from us, I so appreciate your approach to this field and life, CHEERS!!
I am here for an assignment -_- Low key loving this BSN, RN week 2 resource haha. Hands down the most entertaining assignment resource I have ever been given!!
Outstanding, the first RAP "music" that I have ever appreciated and related too.... You need to add 1 more verse discussing the fact that EHR is the single biggest cost center in medical care. The costs of hardware, software, increase paper consumption and entire departments of IT people and layers of administrators that EHR has created are driving up medical costs and therefore insurance costs. More and more employers are dropping employee health insurance plans as a result of the exorbitant cost. When I first started practice in 1992, the biggest complaint of medical cost waste was medical malpractice costs/attorney torte gluttony... that has not changed but those costs now pale in comparison to the waste/costs of EHR.
I am a physician, on our hospital's physician "champion" committee for EHR... Hospital went EPIC this year, we got in 2018 in the office... Your video is so freakin' awesome, It fires on ALL cylinders. I just played it for our medical director, he loved it too and wrote down your links. Thank you. What a great job!
I work in health records of a prison, and we were shown this video at work today... to break the tension of training as get ready to move forward into a EHR system at our facility. I look forward to a lot o things about the system. Funny thing is I don't know if this made anyone feel better about our new system or not, but it did make us laugh, so I appreciate that. :)
This is amazing. And TRUE. I'm glad to be in a place that has physicians involved with the building/customization of the EHR, going over what is built by the analysts and point out how to make it better, fewer clicks, fewer alerts. A billing platform with patient care stuff added on, indeed!
I was doing notes today and literally everything was deleted for no reason. I listen to this to remind myself that I'm not the only one who's eyeballs deep in EHR hell!
Proud to say I moved to specialty and we dictate our notes. INTO A DICTAPHONE. It gets transcribed and when I drop a chart I cuss like a sailor because papers go flying, but you know what happens? I can sort it back into a story and IT. MAKES. SENSE.
Like many of the commenters below I love this video too. So it is now several years since it was posted, but it just came up on my CZcams feed and I clicked on it - I'm glad I did. Speaking as one who is often subjected to the nightmare that going to a hospital or a specialist has turned into, because I have a chronic condition and have to keep regular appointments for checkups, I have seen it get to the point where everybody spends more time now on a keyboard and a computer than they do speaking to the patient. I can sense that most of them do not really like doing this to people, but they are trapped in the EHR system. It has gotten even worse now that COVID has been added into it all. I feel bad for anybody who went into medicine thinking they just want to help others.
Great video. I caught the 'nothing more than a glorified billing platform'. TRUTH. Why can't there be a great EHR? Capatilism! (yay!). We've set up a system to reward providers for what they do. You did X, here's payment Y, it doesn't matter if you gave excellent care. Reward should be given for healing your patients, not doing robot tasks. We COULD have a great EHR, but we have Cerner, Epic, GE, Phillips, Meditech, point-click, athenahealth, and more... and they all want your money. If they made it easy to talk/communicate, that would set a precedent for better EHR software. For now, what's important is to bill for what you did, and to ensure your data is locked up for 'proprietary' reasons... Epic is famous for this. Start rewarding staff for healing patients instead of tasks completed, force EHR inter-compatibility, and outlaw crap EHRs from 35 years ago (Magic), and we'll start moving toward progress.
One of my favorite sayings is "Our software needs to get out of the way and let the care providers treat the patient. They should be paying attention to the patient's care, not caring for the software".
timely post..as I complete an assignment for a gerontology class on the future of technology in long-term care! It is always good to have the practitioner view in comparison to the "pretty picture" view I have on the onside looking in, where it is all sunshine and lollipops. Thanks
I'm almost done with residency, and the EHR pain is real, haha. Been feeling like insurance companies & dodging lawsuits is driving healthcare instead of clinical judgment too often. Thanks for the videos
I was sitting next to a doctor one night and he was so frustrated with trying to figure out how the order system was way to complicated. I turned and made the comment that, " I feel like I have never charted so much about so little in all my life." He smiled and enthusiastically said, "YES, YES,YES....if you don't mind I am going to borrow that saying from you." We both sighed and went about our business.
General Surgeon here. Amen, brother! I've always said that the physician interface is nothing more than an afterthought. And that is the case for all EMRs/EHRs.
+DocNrock Oh, and for what it is worth. Loved the background. Great production. If you ever want any guitar or bass in any future videos like this one, let me know. :)
I am a nurse educator so I use lots of different EMR. EPIC is probably the least offensive, but they need work (a lot). Its true we spend more time with the computers than the clients.
No system is perfect, but in a world where every other industry has joined the modern world, it's well time that healthcare does as well. Of course, we could always regress to the days where there was one paper chart shared over the continuum of care with sloppy handwriting and no ability to mine data or efficiently search through it.
+josh myers well that's exactly it: every other industry has gotten more productive with tech...EXCEPT healthcare! Why can't our tech actually help us be better, safer, more efficient caregivers, instead of creating more work, more obstruction, more fraud, more errors? Our patients deserve better than the crap we're forced to use currently. It's not always the vendors' fault either-government mandates, insurance billing requirements, HIPAA, etc. all collude to make our software disastrously unusable. This video is a call to action to improve our software, not to go back to paper.
Back in the 80's I knew I would grow up and become a Hospice RN. I actually touched my pt. I held their hand, looked in their eyes, And actively listened. One day I went to work and a laptop was shoved inbetween my pt's face and my care. It was mandated I chart while giving care. My pt's face became key strokes. I apologize constantly for the 3rd party at the bedside. God help those at and in the hospital bed.
I use paper. It has worked for years and still does. I write the progress note while with the patient and it is done by the end of the visit. Very simple and fast.
I'm a 10 year veteran of EHR implementation, conversion, system management and interoperability from the IT side, and all I can say is: this is absolutely on the money. Bravo. The only caveat: there's no reason to think athenahealth doesn't suck as much as the other EHR brands; the main difference is that athenahealth is cloud-based, or in other words, "running on someone else's computer."
+paul land Hi Paul! You are absolutely correct; I am in no way endorsing ANY EHR system (I've not used Athena's, but I've had experience with Cerner, Epic, McKesson, VA CPRS, PracticeFusion), and I do endorse the idea that IT vendors should listen to clinicians, and not just hospital systems focused solely on regulatory compliance and billing efficiency.
Darn all those disconnected information silos. It's so frustrating when departments don't connect electronically. At least it was easier to walk a paper record to a different department in the old days even though paper has its drawbacks.
Well, amen. I entered "Foley catheter".....Nothing. EMR never heard of that. Finally found out I should have entered "indwelling urethral catheter?! Really? that's a billing name, right? "Hey, while you're up, would you get me an artificially sweetened, carbonated, cola flavored beverage? Thanks." The new thing now is checking (and posting in the doctor's lounge) my percentage of orders that I hand entered, vs verbal orders. The pressure is to hand enter every order myself. Will medical care be better if I am a doctor full time, and also a clerk? Or is it possible that adding a whole other job will take away from doctoring? If my percentage of order entry goes up, is that good? For whom? According to my study set for boards, "A seminal study found increased mortality in a pediatric intensive care unit after implementation of a commercial CPOE system, attributable in part to an unnecessarily cumbersome order entry process that reduced clinicians availability at the bedside" Templates and canned order sets can speed the process up, but time spent entering stuff is time spent doing clerk stuff. I'm a doctor. The pressure to hand enter 100% of all orders, notes, etc. immediately is probably to benefit the hospital system's desire to offload all their medico-legal responsibility from the whole process.
I totally get it Stephen, but we can not drink !!!!!!!! Water is a no no unless you leave critically ill babies to just chill in the password protected, super duper lounge. NOT It is ridiculous.
Haha saw this video during a meeting-really funny and good video! Maybe try looking into getting Scribes at your site! We help doctors, PAs, and NPs focus more on patient care while doing a good amount of the chart for providers.
I'm a physician writing up my PhD thesis on how to visualise patient data in a way that mirrors how we clinicians think. I am going to offer the reader the choice of reading 5,000 words of a literature review, or simply spending 5 minutes watching this stroke of GENIUS.
This is great!! The device we use from our home health care office leaves a LOT to be desired!! It is also in real time so it gets ridiculous when my vent patient has three things going on at the same time!! 😒 I’m actually happy when it goes on maintenance mode for my shift and I can chart on paper!! 😆
The hospital I work for went live with EPIC (fail) 2 months ago. It has been a nightmare for us. The education was terrible and the training was virtual(ly non-existent). Patient care takes backseat to doing stuff that's never been in our job description. My nurses are now having to reconcile billing and coding errors....WHY do we have a billing and coding department if my nurses and techs now need a certificate in billing and coding just to check vitals? It's a disaster. 30 min time slots for cardiac testing has now increased to 45 min just so we can clicky clicky our way through the chart and 900 tabs.
As a 25 year physician veteran of the ED, I can honestly say that what I have seen is the EMR's decrease quality of care, take time away from patients, and are one of the last straws on this camel's back to get out of medicine, or should I now say health care business.
Come on folks, the EMR is magical. I went to a specialist and was never touched or examined. Magically, my complete physical appeared on my online EHR the following day. I am so grateful that they didn't find anything wrong with me.
Love the EHR video. Jokes/Raps aside, this is the real situation. Doctors spend more time dealing with data and order-entry than with patient care. All my research is focused on addressing this problem. The big companies care little about the real human centered problems... they are well aware of the problems, but their engineers are trained in system design not human-centered design. Cerner, Epic, McKesson, GE, etc all need human computer interaction designs that control the design of these system.
I live in a country in which electronic prescriptions are still a rare thing and every medical history is on paper inside carton folders (we pharmacists/nurses/everyone who isn't doctor deal with bad handwriting and guessing what it says, though). But I've read some prescriptions pharmacists receive in the US and I can't believe my eyes...and the time they spend calling the nurse to ask what the doctor meant. Doses that don't make sense (or mg instead of ml and viceversa), quantities not compatible with the days of treatment, directions like "do not take by mouth" for omeprazole tablets and some typos which clearly were made by a computer.
Former Epic employee here: Your EHR software is still running old subroutines written in the 1970's with an ancient tech stack that hasn't been updated in 50 years. You're right, it's terrible. I think it's criminal to force highly trained medical doctors to spend their time doing data entry work on these systems instead of helping patients. This video was spot on.
Visual basic 6 ?
My cremain's niche is going to have 'Epic Sucks' on it, no kidding, I'm having the last say! Thanks for the ward clerk shout out too! I was one 25 yrs ago, but went into study coordinting and trying to use Epic for a RCT--ha!
@@NevilleDasturMUMPS
This video is 100% true. I feel like I treat computers all day, not patients.
Totally. I can’t do it anymore.
I watch these and think how I miss that life, then these IT nightmare memories come flooding in like PTSD. NOPE
i love this video, i am a nurse and my poor doc is always complaining about it taking 20 clicks to do one thing. I never thought when i went to nursing school that i would spend nearly all my time in front of a computer and only a small amount of time with my patients. I am sure doctors feel the same way, we went to school for our patients not for computers and insurance companies.
I'm a medical transcriptionist transcribing the poorly dictated reports from dictators. Our pay has been cut by 50% since the middle man came between the transcriptionist and the dictator!
Great video! But the truth is... EPIC works for us.
Utibe Effiong are you in admin?
That or you actually spend a good amount of time with your patients but have to spend 2+ hours after the shift is over catching up on charting, education and care plans which takes away from time you could spend getting some good sleep so you're at your best to care for your patients. I hope technology will catch up in health care soon so CMS, TJC, et cetera can get the information they are needing without compromising patient care with the patient's care team either giving patients less time due to charting requirements or quality of care if they have to stay after their shifts end solely for charting purposes and aren't able to get good sleep if they work that next day or night.
My niece is getting ready to start a mentoring program as a new RN. I really feel for her. 🥺
William R. Reed, MD , PNHP, Chicago. Long time general internal medicine MD.EMR: Epic, Allscripts are truly awful. They were designed only for billing and pharm prescribing. This Video and Rap are 100% accurate.
Love the video.....Ya don't miss your water until your well has run dry........I say that because we MTs (medical transcriptionists) DO matter!!!! We've been screaming this loudly for years but no one wants to hear us! There are sooooo many of us well qualified, experienced MTs who'd LOVE to get back to transcribing so the doctors can be doctors to their patients! Thought cutting out the MTs and bringing aboard EMRs would help save time and money??!!! It's been more costly in the long run. Bring us transcriptionists back - whether its transcribing directly into the EMR or straight transcription!
Absolutely love this video. Just switched to Epic a few weeks ago at my hospital. This video made all our PAs laugh so hard pretty sure I had some stress incontinence.
So true, so true. As a former ED and ICU nurse, and current Director of Clinical Informatics, I have been trying to make usability the focus of EHR unsuccessfully. So glad you are speaking up. How can I help? Not only #LetDoctorsBeDoctors but also #LetNursesBeNurses
bring back a place in the EHR for a narrative note. one that consultants can sing off that they read on rounds like the old progress note.
simplify,simplify, simplify- one to two clicks per task
"thirty clicks for ambien"--love it!!
I'm on epic, sometimes not so epic!
I quit my long-time position I loved, that I thought I'd retire from, over a horrible EHR rollout. When I realized that no one cared about patients anymore, that the only thing which mattered to my bosses was the checkbox, I knew I had to leave before I killed a patient (or them, or myself). I just love this video so much....ever since it came out, I play it all the time - for my colleagues, my medical students, my friends who work in healthcare IT, and pretty much anyone who will listen to my EHR rants! Thank you for being the voice of reason and unity against the madness!
A bad EHR rollout can end careers, full stop. We need to do better.
It ends careers before they even start. I was in nursing school for a while, after having been in EMS for about two years. I figured it was time to expand my horizons and move up. I had full intentions on becoming an RN/PHRN (pre-hospital RN), but the whole EHR thing just got to be too much. I felt as though I was doing my patients an incredible disservice by essentially treating a machine, and it was just so WRONG. So back into EMS I went, where I was still (and still am) able to actually treat my patients and even *gasp* converse with them! EMS Charts isn't exactly peaches and cream, but it was, compared to disastrous EHRs. There was no escaping EPIC either, because the only two hospital groups (read: insurance companies) who bought out literally every hospital in my area, all use EPIC. God bless those who are on the EPIC front lines, using that godforsaken interface every day. I commend you all!
I feel ya, but the problem is too many options and no one wants to standardize. Everyone wants their own app and IT has to try to jury rig them all to work together. Keep in mind, Apple "just works" because they clamp down harder than a hemostat on the software. If we had that much power it would work beautifully.
I've been clinical and IT, I understand the frustration on both sides. The problem often is that the decisions get made by people who aren't in either camp, beancounters looking for a deal.
amen! when EMR first was being talked about, I was so excited because it was going to streamline communication, force everyone on the care team out of their silos, and create a wonderful dialogue among providers about patient care. Sadly, it has fallen so short of the original idea, it isn't funny. The problem is one that I wrestle with daily - how to realize the promise when this platform is incompatible with that platform, so here we all are - once again - in damn silos.
After a little more time on the IT side I'm finding another problem is that of communication. Each side believes it knows best and there appears to be a failure to appreciate the experience of the other.
I'm fortunate to be in a team of Lab IT staff who have all come from the Lab and were then trained into the IT positions. I'm kind of a unique person in that I worked in IT for many years and then trained to be an MLTS when the computer racket no longer gave me joy. But we often get the Lab making instrument purchases without first consulting us to see whether or how well it can be interfaced with the LIS and then they complain when we tell them how expensive it will be to interface or that features they wanted turn out to not be compatible with the LIS. Then on the other side, hospital ITS tries to force software changes on the Lab that don't meet DAP or CAP requirements or require major retooling or other changes to the lab.
I don't know if it's so much a matter of neither side wanting to consult us or they just seem to forget that that's the kind of thing we're here for. Nonetheless it creates frustration on both sides and doubles our frustration because it multiplies our workload.
If you ever thought the lab was underappreciated, just know it could be worse; you could be Lab IT. The lab doesn't appreciate our lab experience at times and IT thinks we're just clinical staff pretending to be IT.
I am clinical currently, working on getting my HIMT degree. I have been around computers since birth, with my Dad being a white hat since the early 1980s. I have done hospice care since I was 10 - first for my family and now to help other families and their loved ones. So I get the frustration on both sides. I'm all for clamping down harder than a hemostat. I have been thinking about ways to "force" the technology to interface among providers, specialists, and hospitals on differing platforms. The only thing I can think of is to create a hard-lined "intranet" which works on cloud computing with entirely discrete servers from the world wide web. Each platform must display the equivalent of a uniform language to be "understood" by the network. As far as making stuff user friendly, the hardware already exists (iPad, for example). All we need to do is create software which interfaces with the desktop that these poor end-users are trying to drag around their facilities. The only visible answer to me is such an enormous undertaking that nothing short of getting CMS involved would bring it about. I don't think the Lawmakers even see the problems we are facing down here on the ground. What say you? Would this work - or is there another way to help with the information silos? Granted, only each facility can make the determination to actually ASK us, but I think this is a problem which can be solved with decent management sticking up for us - our scope of practice. I'm all for letting doctors and nurses practice to the top of their game, but their management needs to allow us to practice at the top of our game. We are on the same team - management needs to start seeing that fact.
My point exactly. Why can’t there be a standardized EHR system? Plus providers do charts differently.
Bring back Medical Transcription and let the doctors take care of their patients face-to-face!
GREAT VIDEO ZDoggMD! I love it!I've worked on a GI/Ortho/Pulm/Pain/Cards... documentation system for many years. From the software side, we try really hard to listen to the clinicians and make the software as smooth and seamless as possible. I like to think we've done a good job and are VERY happy get feedback from clinicians.Of course we have to meet the ever changing quality & legal requirements or people won't/can't buy our software. The challenge always seems to be: make the software flexible enough to support all the medical scenarios but keep it elegant so it doesn't get in the way of the provision of care.We've stuck to certain areas of healthcare that are 'better suited' for standardized documentation and had some luck.To all you providers from an IT guy: I am very sorry for the stress we cause you. The reason I go to work everyday is because of you!
As a doctor living in a bubble I don't get to hear things like this very often that connect on such a deep level that it reminds me of those times during high school when we all thought the songs were written just for us and could listen to them over and over again. I am tempted to get a flat screen and loop his youtube channel in the Care Practice Clinic lobby. I can't believe I missed the fact that Zubin was still doing these the last few years.
We are working on a huge integration of three hospitals to one coherent system. I play this song in the background while waiting for meetings to start. Its gets everyone in a lighter mood and improves the quality of the meeting! Thank you!
I love it Heidi! Thanks for this 🙏❤️
ZDogg,
One of my patients here in central North Carolina where several platforms were birthed was a software designer. At one of her visits (this was 6-7 years ago) tried to convince me how great EHR was going to be (still on paper back then). In the process, her whole argument was based on the templates making the visit audit-proof for level of service, improving reimbursement. Not one argument for improving actual care.
The basic problem is the inability of the government, after mandating EHR by 2014 (now delayed how many times) to not stand up & choose a single base code ALL systems had to be based on so that true communication nationwide could occur.
Since that will never happen, thanks for coming up with a clever means of pointing all the deficiencies out. Fortunately, I only need to put up with this BS for another few months before hanging up the stethoscope for good. Good luck to those of you carrying on.
Zdogg we use windows 98 + Epic Fail. It takes me 99 clicks and my patient ain't one. Respect!!
+Effort Award We fix EHRs and it'll be 99 problems but a click ain't 1.
+ZDoggMD you should do an "I can't feel my face" song but instead do "I can't feel my arms or legs,high spinal".
Did you get that from ZDADD MD !!!!!! LOL I just love your Mom and Dad!!!!! They should get a spin off channel! I love your impressions, but they have much better English. This EHR that was cheaply pieced together for NICU in Cerner is awful. The neos cant even see our notes in some places??? We can not see the M.D. notes. The pharmacy is different as well. I just want to pull my hair out. I love babies not square computer screens. Keep on talking about important issues. I have been a NICU nurse for 18 years, and it makes me want to stop what I love. I won't.....
ZDogg you said everything we docs been saying. As docs we lost that human touch and we're treating computer screen. We need a new chart!
its funny I was watching this again and totally get it - but after seeing the alternative, here in Vietnam.. where EHR Is really very new and only in private hospitals. in public its complete paper files, recopying, chaos with continuity, new files made for each admission, no records tracking.. no history available on readmission. Electronic really does increase safety! A happy medium is best..
Equal access can be achieved by keeping paper records and scanning the entirety of the chart at end of admission. Using an ehr is absolute torture and will prob shorten my career by 50%
Thank you for bringing this issue to people's attention. As a nurse for 20 years, who has worked in IT for almost 10 years, I am very frustrated with how difficult the EHRs continue to be for end users. Daily we have discussions around how the process should dictate the EHR and not the other way around. I work now in data analytics and am a proponent of electronic documentation and interoperability but as long as all the vendors care about is selling their systems and nothing "talks", clinicians will continue to be frustrated. I can do everything on my smartphone with a touchscreen except chart on a patient. Meanwhile the data that we should be using to increase safety and efficiency of patient care exists in a black hole somewhere that no one can share.
Yay! It has been released! Sadly typing doesn't help when you have to click the boxes using mouse - no touch screens except in our pockets! Love how you envision patients seeing the record with us - rotated with a doc who would dictate his notes with the patient at the end of the visit and let them correct any errors!
Internet down - can't pull up patient's charts. Then the patient doesn't know why they're here and neither do we. Internet down - there goes escribe. Prescription pads? What the hell are those?
I'm just lucky I'm young enough that I had typing class in school. I see some older folks hired that know what they're doing, but the biggest barrier to them is typing.
Yep! Because I type fast, charting is a breeze, but the second our system goes down, then what? We have to pull paper records for EVERYONE.
No joke on the typing, I'm soooooo slow. I prefer speech recognition software but ya GOTTA proofread that.
You made my week!! I am a primary care doctor who had what was left of my trapezium removed earlier this year....so the wrist reference was appreciated!
Great talent...great message!!
Thank you! As a Risk Manager for a physician-owned liability company, you hit the nail on he head! Physicians and other care providers are torn between providing quality care and meeting mandated requirements. Let's hope this catches on and turns into a movement! I'm sharing with my colleagues!
I am a pediatrician and I LOVE YOUR VIDEOS!! I feel like someone is speaking for us (the healthcare workers who actually try/care)!!
I love zzdogg 2
Clinical staff needs to be involved with developing their workflows. Application folks don't magically know what they want. Complaining about it doesn't help - be constructive, be cooperative. Help IT create what you need/want to be successful.
+WindingBend WERD.
I would have loved that opportunity but admin shoved it in our face and said use it, we don't really care if you hate it.
As an ehealth person (in South Africa) I LOVE this video. Brilliantly summarises many of the challenges of going electronic. Health geeks unite!
The most important component of Patient Care that is Human Touch has been eliminated by these computers. Healthcare providers have been turned into robots and machines. We must demand for a patient-provider friendly universal EHR that can keep the humanity alive among us.
+HEALTHCARE NOT FAIR #BOOM. Love your videos BTW!
+ZDoggMD Thanks so much. You ROCK man!!! Keep going. I always make sure to keep on spreading your message to as many ppl as I can and they all love it.
you're going places when you have a helicopter in your videos.
+klackattack hahaha suck it Trump!
+ZDoggMD I like to imagine you guys waiting around until the copter actually came and then everyone running out side to get it in the shot
+Lonnie Ducote Actually, we were shooting a rap scene and heard it firing up, and just panned the camera upwards. #Serendipity
hahaha, nice. Amazing video, your work is growing exponentially
+ZDoggMD perfect timing !
Patients hate EHR too. When I was in the hospital I couldn't get food for a day until they figured how to get my special diet mods in the computer. Instead of looking at patients docs/nurses are forced to look at the screen and enter data. Really makes it hard to have a good relationship with the team.
"If someone say it's epic we say it's epic failure." Brilliant ZDoggMD! You continue to delight, amaze and enlighten! BigLove and Respect from HealthyThinker
I love this video and I love the channel. I'm a 3rd year pre-med student and my Introduction to Biomedical Informatics course is using this as a resource for one of our units. I'm dying over here knowing every student gets to see the brilliance of this man and his team.
That is incredibly specific! And so well done! Kudos. I will share this with my doctors next time I go.
Dr. ZDogg. I'm a medical transcriptionist, and we do good work. EHR cut us out of the loop. I know you don't believe it, but MTs are professionals and we catch lots of ERRORS in medical records and flag them so they can be clarified. The old system WORKED - all it needed was to be stored in digital form instead of paper form. They fired most of the U.S. MTs and most work that is still being dictated is being outsourced to India and Pakistan. Sorry, I know they say those MTs speak flawless English, but they don't. I worked in Quality Assurance, and had to do their QA for them. That was after being typed by an overseas MT, being reviewed by a first-line and second-line overseas QA supervisor. Then in final desperation they would send the report back to the U.S. where we would have to correct it. All this for the sake of economy. Where is the economy in having someone type for 2 cents a line when it has to be held up for review and 3 more people have to handle the document, just adding to the cost? Please just go back to dictation and let MTs do what they do best - turn out a quality report with minimal errors. The company where I work makes us maintain a 99.7% accuracy rate, and that's pretty darn high compared to EHR. And you don't even want to get me started on voice recognition. That's a nightmare. I am so happy I found Let Doctors Be Doctors! MTs are behind you. Believe me, we understand, too.
+Pia Nicole Desselle Amen Pia. How do you point and click a detailed history and physical? We medical transcriptionists can get every.single.detail in that record quickly and accurately. Do you know how many medical reports MTs can turn out in a shift? Probably in the time it takes to chart one patient record into the EMR system an MT can complete five-plus reports. I'm a 25-plus-year MT and will happily do ALL of your reports.
+MrsC48 The reason "they" as in the regulators, don't like what MT's do, is because it's not neat and tidy in a data base.
+Stacey Gordon There is a solution to the problem. It is 2015 and text mining and machine learning can take ASCII text and write the data to a structured database. Each element in the database can be linked to the exact location in the free text so that text mining errors do not become "facts".
+Hamp Howell These days Voice Recognition is used a lot, and if you speak really clearly there's very not much left for an MT to clear up....but there's always something. Best of both worlds! There'll always be work for a good transcriptionist.
+okierazorbacker Well, then please let the transcription companies know about this miracle, because what you are saying is patently false. I see those reports every day and if I showed you the garbage those VR programs turned out, you wouldn't be so quick to say that. Do the job of an MT who is trying to clean up a report dictated while a lithotriptor is working in the back ground or while the hospital paging system is summoning doctors for a code, and all the alarms are going off at the nurses station where the doctor or nurse is dictating from and see what kind of speaking clearly is going on. It's not. And let's not even talk about ESL dictators, or a doctor who sounds like he graduated from the 5th grade instead of having gone to med school. It's the MT's job to correct his language until he sounds like a professional instead of someone who doesn't give a f%$@. Let me guess, you're not an MT, you're a programmer who THINKS VR works.
@ZDoggmd, I just found you a short while ago and I have to say you are a breath of fresh air, been an NICU RN for 28 yrs and the way healthcare has changed makes one wonder why anyone continues to work in this field. Thanks for the humor that we once had and "the man" and "politically correctness" has taken from us, I so appreciate your approach to this field and life, CHEERS!!
LOVE YOU ZDOGG--- we are in the middle of transitioning to the first FULLY DIGITAL HOSPITAL in North America....your rap rings true!
Amazing production, amazing message. Let's get every CIO and every EHR vendor to watch this ... on loop .. eyes opened Clockwork Orange-style.
Whoever shot this is amazing.
I am here for an assignment -_- Low key loving this BSN, RN week 2 resource haha. Hands down the most entertaining assignment resource I have ever been given!!
Outstanding, the first RAP "music" that I have ever appreciated and related too.... You need to add 1 more verse discussing the fact that EHR is the single biggest cost center in medical care. The costs of hardware, software, increase paper consumption and entire departments of IT people and layers of administrators that EHR has created are driving up medical costs and therefore insurance costs. More and more employers are dropping employee health insurance plans as a result of the exorbitant cost. When I first started practice in 1992, the biggest complaint of medical cost waste was medical malpractice costs/attorney torte gluttony... that has not changed but those costs now pale in comparison to the waste/costs of EHR.
+Scott Merlo Once again, I say WORD.
Just started dealing with EHRs through my health informatics program, will keep this in mind.
I am a physician, on our hospital's physician "champion" committee for EHR... Hospital went EPIC this year, we got in 2018 in the office... Your video is so freakin' awesome, It fires on ALL cylinders. I just played it for our medical director, he loved it too and wrote down your links. Thank you. What a great job!
I work in health records of a prison, and we were shown this video at work today... to break the tension of training as get ready to move forward into a EHR system at our facility. I look forward to a lot o things about the system. Funny thing is I don't know if this made anyone feel better about our new system or not, but it did make us laugh, so I appreciate that. :)
This is amazing. And TRUE. I'm glad to be in a place that has physicians involved with the building/customization of the EHR, going over what is built by the analysts and point out how to make it better, fewer clicks, fewer alerts. A billing platform with patient care stuff added on, indeed!
I was doing notes today and literally everything was deleted for no reason. I listen to this to remind myself that I'm not the only one who's eyeballs deep in EHR hell!
Proud to say I moved to specialty and we dictate our notes. INTO A DICTAPHONE. It gets transcribed and when I drop a chart I cuss like a sailor because papers go flying, but you know what happens? I can sort it back into a story and IT. MAKES. SENSE.
Awesome! I'm a family doctor in Toronto and our EHR sucks. It's our second and we're moving onto our third, which will no doubt suck as well.
Like many of the commenters below I love this video too. So it is now several years since it was posted, but it just came up on my CZcams feed and I clicked on it - I'm glad I did. Speaking as one who is often subjected to the nightmare that going to a hospital or a specialist has turned into, because I have a chronic condition and have to keep regular appointments for checkups, I have seen it get to the point where everybody spends more time now on a keyboard and a computer than they do speaking to the patient. I can sense that most of them do not really like doing this to people, but they are trapped in the EHR system. It has gotten even worse now that COVID has been added into it all. I feel bad for anybody who went into medicine thinking they just want to help others.
Great video. I caught the 'nothing more than a glorified billing platform'. TRUTH. Why can't there be a great EHR? Capatilism! (yay!). We've set up a system to reward providers for what they do. You did X, here's payment Y, it doesn't matter if you gave excellent care.
Reward should be given for healing your patients, not doing robot tasks. We COULD have a great EHR, but we have Cerner, Epic, GE, Phillips, Meditech, point-click, athenahealth, and more... and they all want your money. If they made it easy to talk/communicate, that would set a precedent for better EHR software.
For now, what's important is to bill for what you did, and to ensure your data is locked up for 'proprietary' reasons... Epic is famous for this.
Start rewarding staff for healing patients instead of tasks completed, force EHR inter-compatibility, and outlaw crap EHRs from 35 years ago (Magic), and we'll start moving toward progress.
Another wonderful installment! Got to love all that they make!
You are the best! ED scene to a "T" (sheet) perfection!! Keep it up!
Crumbs. Why has it taken me so long to see this…. It’s 8 years old!
One of my favorite sayings is "Our software needs to get out of the way and let the care providers treat the patient. They should be paying attention to the patient's care, not caring for the software".
Awesome vid. Thanks for mentioning radiographers! :)
May I just add my endorsement of this video by reiterating it's point: "EHRs suck!" and "We need a new chart." Thanks, ZDoggMD.
timely post..as I complete an assignment for a gerontology class on the future of technology in long-term care! It is always good to have the practitioner view in comparison to the "pretty picture" view I have on the onside looking in, where it is all sunshine and lollipops. Thanks
Where have you been all my life doc?
I found your songs after being a nurse for 17 years... man your music is so funny yet so real... love it!
Amen!! I'm a mid-level and I have to know 3 different EHR systems I feel like all I ever do is just chart!
No doubt! Same here and they don't share data. Don't get me started on consents...
I'm almost done with residency, and the EHR pain is real, haha. Been feeling like insurance companies & dodging lawsuits is driving healthcare instead of clinical judgment too often. Thanks for the videos
As a nurse, I thank you very much for the video appreciating nurses!
I worked for a hospital that used EHR A for the emergency room and EHR B for the rest of the hospital. It as much fun as you would expect
Your channel is a thousand times more awesome and exciting than I realized when I first stumbled on it, and I'm thrilled
Happy (but not happy ) to see everything is the same , everywhere! Montreal Canada
I was sitting next to a doctor one night and he was so frustrated with trying to figure out how the order system was way to complicated. I turned and made the comment that, " I feel like I have never charted so much about so little in all my life." He smiled and enthusiastically said, "YES, YES,YES....if you don't mind I am going to borrow that saying from you." We both sighed and went about our business.
Word, please keep them coming.
If you are in the healthcare profession this is the best channel you will ever find. Ha ha ha. Genius.
How is it possible this video only has 10,000 likes
AMEN!!!!!!!!!!!!! I demand quality back into patient care!!!!! Every line in this song is 100% spot on.
Our ehr has been down for a week !!
Beautiful Z dogg! Nothing has changed since you rapped this 3 years ago!
Awesome!!!! Wish our hospital had someone like you guys!!!!
We need more videos like this!
General Surgeon here. Amen, brother! I've always said that the physician interface is nothing more than an afterthought. And that is the case for all EMRs/EHRs.
+DocNrock Oh, and for what it is worth. Loved the background. Great production. If you ever want any guitar or bass in any future videos like this one, let me know. :)
+DocNrock Thanks homie!
I am a nurse educator so I use lots of different EMR. EPIC is probably the least offensive, but they need work (a lot). Its true we spend more time with the computers than the clients.
thank you!! so great. laughing (and crying!) aloud! -- CNM for more hands on care, less computer screen time
as an internist / geriatrician is worst for us..saving the world one long note at a time.. Good stuff!
Fantastic, need more voices like this. Good to see the young doc's are as frustrated as the older generation.
As a medical transcriptionist - I love this!
Keep doing what your doing bro!!! U r our voice!!!!
Just came through a year and a half of family practice, 2-3 times as much time Demanded with the EMR than with my patients...I am so over it.
Congrats! It's amazing how many of the key issues you captured. Love the messages, music and rhythm!
No system is perfect, but in a world where every other industry has joined the modern world, it's well time that healthcare does as well. Of course, we could always regress to the days where there was one paper chart shared over the continuum of care with sloppy handwriting and no ability to mine data or efficiently search through it.
+josh myers well that's exactly it: every other industry has gotten more productive with tech...EXCEPT healthcare! Why can't our tech actually help us be better, safer, more efficient caregivers, instead of creating more work, more obstruction, more fraud, more errors? Our patients deserve better than the crap we're forced to use currently. It's not always the vendors' fault either-government mandates, insurance billing requirements, HIPAA, etc. all collude to make our software disastrously unusable. This video is a call to action to improve our software, not to go back to paper.
Im a Nurse Case Manager and all.of your videos are AMAZING ❤
Back in the 80's I knew I would grow up and become a Hospice RN. I actually touched my pt. I held their hand, looked in their eyes, And actively listened. One day I went to work and a laptop was shoved inbetween my pt's face and my care. It was mandated I chart while giving care. My pt's face became key strokes. I apologize constantly for the 3rd party at the bedside. God help those at and in the hospital bed.
I use paper. It has worked for years and still does. I write the progress note while with the patient and it is done by the end of the visit. Very simple and fast.
I'm a 10 year veteran of EHR implementation, conversion, system management and interoperability from the IT side, and all I can say is: this is absolutely on the money. Bravo.
The only caveat: there's no reason to think athenahealth doesn't suck as much as the other EHR brands; the main difference is that athenahealth is cloud-based, or in other words, "running on someone else's computer."
+paul land Hi Paul! You are absolutely correct; I am in no way endorsing ANY EHR system (I've not used Athena's, but I've had experience with Cerner, Epic, McKesson, VA CPRS, PracticeFusion), and I do endorse the idea that IT vendors should listen to clinicians, and not just hospital systems focused solely on regulatory compliance and billing efficiency.
Darn all those disconnected information silos. It's so frustrating when departments don't connect electronically. At least it was easier to walk a paper record to a different department in the old days even though paper has its drawbacks.
Well, amen. I entered "Foley catheter".....Nothing. EMR never heard of that. Finally found out I should have entered "indwelling urethral catheter?! Really? that's a billing name, right?
"Hey, while you're up, would you get me an artificially sweetened, carbonated, cola flavored beverage? Thanks."
The new thing now is checking (and posting in the doctor's lounge) my percentage of orders that I hand entered, vs verbal orders. The pressure is to hand enter every order myself. Will medical care be better if I am a doctor full time, and also a clerk? Or is it possible that adding a whole other job will take away from doctoring? If my percentage of order entry goes up, is that good? For whom?
According to my study set for boards, "A seminal study found increased mortality in a pediatric intensive care unit after implementation of a commercial CPOE system, attributable in part to an unnecessarily cumbersome order entry process that reduced clinicians availability at the bedside" Templates and canned order sets can speed the process up, but time spent entering stuff is time spent doing clerk stuff. I'm a doctor.
The pressure to hand enter 100% of all orders, notes, etc. immediately is probably to benefit the hospital system's desire to offload all their medico-legal responsibility from the whole process.
+Steven Smith They don't make lawyers be court reporters at the same time as doing their lawyer thing. Just sayin'.
I totally get it Stephen, but we can not drink !!!!!!!! Water is a no no unless you leave critically ill babies to just chill in the password protected, super duper lounge. NOT It is ridiculous.
Foley should have picked up every Foley, come on. But I have encountered the same with newborn discharge. Really?AHHHHH
AMEN!!!!!!!! I used to pay attention to my patients and now my focus is all on the computer and I have been blaming myself!
Haha saw this video during a meeting-really funny and good video! Maybe try looking into getting Scribes at your site! We help doctors, PAs, and NPs focus more on patient care while doing a good amount of the chart for providers.
I'm a physician writing up my PhD thesis on how to visualise patient data in a way that mirrors how we clinicians think. I am going to offer the reader the choice of reading 5,000 words of a literature review, or simply spending 5 minutes watching this stroke of GENIUS.
This is great!! The device we use from our home health care office leaves a LOT to be desired!! It is also in real time so it gets ridiculous when my vent patient has three things going on at the same time!! 😒 I’m actually happy when it goes on maintenance mode for my shift and I can chart on paper!! 😆
I'm with an LIS vendor.... love your videos. And we're working on it :)
The hospital I work for went live with EPIC (fail) 2 months ago. It has been a nightmare for us. The education was terrible and the training was virtual(ly non-existent). Patient care takes backseat to doing stuff that's never been in our job description. My nurses are now having to reconcile billing and coding errors....WHY do we have a billing and coding department if my nurses and techs now need a certificate in billing and coding just to check vitals? It's a disaster. 30 min time slots for cardiac testing has now increased to 45 min just so we can clicky clicky our way through the chart and 900 tabs.
As a 25 year physician veteran of the ED, I can honestly say that what I have seen is the EMR's decrease quality of care, take time away from patients, and are one of the last straws on this camel's back to get out of medicine, or should I now say health care business.
So....had a free couple of hours and checking out all of your videos. I would like to be your ZDogg NP! I like your vision of healthcare! Kudos!
This one is now my favorite. You are the MAN
Come on folks, the EMR is magical. I went to a specialist and was never touched or examined. Magically, my complete physical appeared on my online EHR the following day. I am so grateful that they didn't find anything wrong with me.
Don't stop Zdogg - Love you!
My informatics class just had me watch this video. Dr. Z, still the best! Still good stuff with charting still needing work.
Love the EHR video. Jokes/Raps aside, this is the real situation. Doctors spend more time dealing with data and order-entry than with patient care. All my research is focused on addressing this problem. The big companies care little about the real human centered problems... they are well aware of the problems, but their engineers are trained in system design not human-centered design. Cerner, Epic, McKesson, GE, etc all need human computer interaction designs that control the design of these system.
+Dr. Anthony Faiola, Ph.D. You are correct, sir.
I live in a country in which electronic prescriptions are still a rare thing and every medical history is on paper inside carton folders (we pharmacists/nurses/everyone who isn't doctor deal with bad handwriting and guessing what it says, though). But I've read some prescriptions pharmacists receive in the US and I can't believe my eyes...and the time they spend calling the nurse to ask what the doctor meant. Doses that don't make sense (or mg instead of ml and viceversa), quantities not compatible with the days of treatment, directions like "do not take by mouth" for omeprazole tablets and some typos which clearly were made by a computer.