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Healthcare Workarounds Expose EHR Flaws
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SeanDo40
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SeanDo40,
User Rank: Apprentice
3/26/2013 | 6:40:04 PM
re: Healthcare Workarounds Expose EHR Flaws
I experienced this just the other night. I was at my son's karate class and sitting in the parent's area was a nurse, still in scrubs, with a spiral bound notebook in her hand. The title on the notebook "patient notes". On her knees balanced a Toshiba Tecra laptop. She was busy transcribing the paper notes to an EHR application.
Couple of things come to mind. A) With context aware security she should never be allowed access to the EHR app when outside the geo fence of the hospital. B) How does this practice not violate several compliancy rules? C) Why does she find it easier to do double work than use the technology at the hospital in real time?
pbug
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pbug,
User Rank: Apprentice
3/28/2013 | 1:43:59 AM
re: Healthcare Workarounds Expose EHR Flaws
In one ED near me, the new EHR was down again recently; staff were back to doing everything on paper. In that ED, this means that everything takes much, much longer to do. At a hospital one county over, one doctor tells me that she takes paper notes all day long, and then stays after shift to type everything in, because if not, the system is so bad that she can't actually properly examine and treat her patients in the allotted time. BTW, her hand writing is awful. Her patient instructions are next to impossible to read and act on, and her prescriptions are easily subject to fulfillment errors. But her EHR experience is so bad that she won't even consider any EHR in her own private practice.
pbug
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pbug,
User Rank: Apprentice
3/28/2013 | 1:51:16 AM
re: Healthcare Workarounds Expose EHR Flaws
If, as I describe in my comments, the EHR is so slow and so hard to use during a patients visit that she can't take care of the patient and properly record patient data in the EHR at that time, she does the only thing she knows; enters it after her shift is over. Yes, it is beyond absurd security wise that it works outside the hospital (excepting doctors who may need to work remotely), it is equally absurd that a system be so poorly designed and configured, plus the staff so badly trained, that they have to work extra hours to get the data in. It is also painfully common.
Nickname2000
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Nickname2000,
User Rank: Apprentice
3/28/2013 | 12:30:22 PM
re: Healthcare Workarounds Expose EHR Flaws
I don't think it is correct to blame the EHR. The EHR did not use guerrilla tactics and jump into the health care organization and install itself. EHR's are supposedly planned, investigated, researched by those in authority. Workflows are to be analyzed. If the EHR cannot take care of what the clinician needs to do, it should be changed PRIOR to implementation, or pick a different EHR. All these articles on "EHR BAD" seem to be written by CEO's or Board of Directors of these organizations, whining that after trying to skip important steps, save money on the short term, ignore clinical work process, etc., it didn't turn out as wonderfully as hoped. No kidding.
jaysimmons
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jaysimmons,
User Rank: Apprentice
4/1/2013 | 11:55:54 AM
re: Healthcare Workarounds Expose EHR Flaws
Many of the issues surrounding the EHR should be addressed by management before the EHR gets implemented. When purchasing a product such as an EHR there should be a lot of research and testing performed so providers know they are getting the product that they need. Workflows need to be addressed and the EHR has to be tested to be able to meet the requirements set forth in these workflows. Regarding downtime, which is a big issue as well, providers need to make sure they have servers capable of handling the amount of data and large load associated with running the EHR in their systems.

Jay Simmons
Information Week Contributor
A.Bi
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A.Bi,
User Rank: Apprentice
4/2/2013 | 12:48:31 PM
re: Healthcare Workarounds Expose EHR Flaws
Web based EHR can be a great solution for taking notes. Most web based ehr are smart phones/mobile phones enabled, and they store data on the cloud or remote server. Physician or other related person can access from anywhere with Internet enabled device.


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