Monday, February 11, 2013

Computerized charting

Computerized charting is here to stay, unfortunately.

Unfortunately, because it's all horse$#!^.

Y'see, when they tell us about it before the fact, we're led to imagine someone with the technical skills to take that multi-page paper chart we've used forever, and turn it into a similar electronic chart, with the ability to simply hit the bubbles/check the boxes, and let us enter typed text in the same manner we've charted with pens since quills and inkwells went out of fashion.

Because let's face it, FedEx and UPS track a $20 dollar package with a $5K electronic clipboard, that tells them all about that parcel, including precisely what it is and where it is, with a couple of mouseclicks on the internet, anywhere in the world. Whereas we've been taking care of $500K patients with $1 worth of paper and ink absolutely unchanged since Teddy Roosevelt was president, and functionally unchanged since scribes scratched out the Dead Sea Scrolls 2000 years ago. See if you notice anything upside down with that picture.

But then, wrench, meet monkey. The geniuses who buy this stuff consult all manner of people, from salesmen, to software designers, to computer geeks, and so on. The only people they don't talk to, manifestly, are any people who
a) actually care for actual patients, or
b) have any idea what's necessary.
Such as, just for wild examples, doctors, nurses, technicians, financial staff, etc. If we made movies the way these bozos create and purchase the software, it would be directed by Ray Charles, Stevie Wonder would be the cameraman, and Marlee Matlin would be holding the microphone.

The other lie is that we imagine that we'll be transitioning to state-of-the-art software and hardware.

Not just no. But OH HELL NO. That would cost, y'know, MONEY. So for the "bargain" price of a mere $40,000,000, my employer decided that we'd use MediTech. Google some pithy phrase like "MediTech sucks" and ponder the 17,000 pages that appear on Google, posted by everyone from doctors, to nurses, to actual IT professionals. But wait, there's more!

It's not only expensive as hell, and irredeemably atrocious to use, but by carefully bringing the system up online one department at a time, the day we go hosital-wide, it crashes the entire operating computer systems for every hospital in our system, in several states. That's overacheiving mediocrity on a world-class level, I'm here to tell you.

So then multiple hospitals are back, after months of preparation, onto paper charts for months on end, while the tech genuises try and figure out what the problem is. (Besides evidently, realizing that the chosen software is the problem.) Some people say you can't fix stupid. I say you should let me grab the right size hammer, and give me a crack at fixing it, and I think I could perform miracles.

And understand me, I'm 5-stars all for going to computer charting.
It's just that I suspect, with metaphysical certainty, that I could call up Bill Gates, or the guys at Apple, wave $40M in front of them, and in 90 days I'd have a state-of-the-art medical charting product that would work flawlessly on Windows or Apple platforms, interface with everything from smartphones to car-dash systems to the CT scanners, be accessible to everyone using the system even from the International Space Station, and be designed and updated regularly after exhaustive research and input by the end users, who would swoon in rapture when they viewed the first edition of the finished product. And, coincidentally, enable Microsoft/Apple/whoever to sell said software system to 40,000 other hospitals and facilities on the North American continent and rake in a random few billion dollars or so, year to year. But nooooooooooo.

But the chosen system has three things going for it:
1) It uses a proprietary set up that's compatible with absolutely nothing else.
2) It was designed 30 years ago, and painstaking updated so that it's now only 29 years out of date. For reference, 30 years ago, the height of high-tech screen displays was the drifting white square blipping around in the cutting edge computer game "Pong". I mean, seriously, Meditech would make the guys who flew the Apollo missions to the moon feel right at home. Except they're so old they're dying off.
3) And third, it was originally designed for, approved by, and placed on the Official List Of ObamaCare Compliant Electronic Charting Systems by...wait for it...
the U.S. Government!

So with all that going for it, what could possibly go wrong?!?

Somewhere, there are a couple MediTech salesmen laughing about putting their kids through college on the bonuses they got for unloading this monstrous piece of $#!^ on our hospital group. And there are any number of people in charge of purchasing it for us who should be carefully skinned with potato peelers and slowly lowered skinless into an enormous vat of rubbing alcohol, and their screams broadcast over the hospital paging system 24/7, as a warning to others. Weekly.

But some people are alive simply because it's illegal to kill them. That would include the sellers and purchasers of this monumental mountain of dung.

Instead, most of us, doctors, nurses, and assorted staff, are the ones doing the screaming, and have become fluent in profanity to an unbelievable degree, and the smarter ones - or at least, those better prepared - have installed a small square of closed-cell foam padding at the edge of the desk, so that the inevitable banging your head on the desk multiple times per shift doesn't result in a laceration requiring sutures to repair.

This is what you get when the government "helps" you.

"We had to pass the bill to see what's in it."
That level of asininity would tell you they had to eat the horseapple to see what was in it.
If only I could serve them all the crap sandwiches they so richly deserve.


  1. I live a few miles from Epic, maker of EMR software. The VA uses EMRs which are really nifty although they have gotten a few details wrong- like my chief complaint and my phone number (again) and which eye is blind and wrong prescriptions 3x in a row. Other than that, much better than illegible hand written records. Just venting, nuthin' useful here. Move along.

  2. My gripe is with people who charge Ferrari prices, and deliver not even an Edsel, but a Trabant.

  3. Ugh. UGH I can't even with meditech. It's just so bad it makes my eyes want to bleed every time I look at it.