Thursday, January 27, 2011

A paper cut in a digital world

As I mentally gear up for another week on the inpatient team with our residents, I am vividly remembering a moment from my last week there.

First, a little background.  About five years ago, our hospital went live with an electronic medical record.  True, the documenting system is a bit clunky, but inputting daily progress notes, H&Ps, consults, and discharge summaries electronically became possible.

As a third-year resident here then, I practically leaped for joy.  Gone would be the days of squinting to read Dr. Scribbler's illegible H&P!  Gone would be the days of hunting down a paper chart to read a consult!  I imagined a beautiful new word of efficient legibility.

The majority of the attending staff, as you are probably already imaging, did not share my optimism.  They were unhappy with the clunkiness I alluded to above.  They didn't want to take the time to log in, pull up the right patient, open a new progress note, and type in their thoughts.  "Too many clicks" became their mantra.  The hospital decided to continue allowing paper documentation while the IT folks worked on ways to make physician documentation less cumbersome and more user-friendly.

Fast forward to my time on service last month.  After a lengthy search, I had finally grabbed hold of a patient's paper chart.  As I flipped through the pages to read the surgeon's recommendations for our patient, I felt a familiar sting in my index finger.  A drop of blood welled onto the page I was reading.

Paper cut.  I got a paper cut reading a patient's chart.  Carpal tunnel from clicking the mouse too much?  Ok.  Eye strain from staring at LCD screens for too long?  Understandable.  But a paper cut?!?

It is 2011, and my hospital is still using a hybrid electronic-paper system.  We are far from the only hospital still relying on paper this late into the 21st century.  In all fairness, electronic documentation for physicians does need to become more intuitive and less cumbersome.  But the time has come for us to demand better software, not bury our heads back into the sharp edges of an outmoded paper system.  Resisting better legibility and faster data retrieval denies patients the accurate and timely medical documentation - and care -that they deserve.

Anybody got a band-aid?

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