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The "I Can't Believe There's No Abortion Thread" Part Deux: Electric Boogaloo

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  • St. Clown
    replied
    Originally posted by Swansong View Post
    If you're genuinely advocating for a return to paper charts then I truly don't know what to tell you. Probably a story about buggy whips. You can't blame the system for additional required documentation that you were previously exempted from.

    Implementations are hard. Learning a new system is hard. Data migration is hard. That doesn't mean the system is bad or that the mission isn't worthwhile.


    Everyone's favorite system - in any industry - is the last one, no matter how much they complained about it when it was in use.
    Create a UI that mimics the paper forms, that UI would then transcribe their handwriting to values input into the DB.

    Some level of compromise would be needed for the layout of the form to allow for easy translation from pure free-form to freeish-form. This would make data collection quicker and help reduce transcription errors.

    Leave a comment:


  • Deutsche Gopher Fan
    replied
    Originally posted by Swansong View Post
    If you're genuinely advocating for a return to paper charts then I truly don't know what to tell you. Probably a story about buggy whips. You can't blame the system for additional required documentation that you were previously exempted from.

    Implementations are hard. Learning a new system is hard. Data migration is hard. That doesn't mean the system is bad or that the mission isn't worthwhile.


    Everyone's favorite system - in any industry - is the last one, no matter how much they complained about it when it was in use.
    Lack of coordination of care can also be exacerbated by lack of ehr as I’m sure you’re aware. That’s one of swedens biggest issues- not having access to the right records when needed

    Leave a comment:


  • psych
    replied
    We still use paper charting. *shoulder shrug*

    Leave a comment:


  • Swansong
    replied
    If you're genuinely advocating for a return to paper charts then I truly don't know what to tell you. Probably a story about buggy whips. You can't blame the system for additional required documentation that you were previously exempted from.

    Implementations are hard. Learning a new system is hard. Data migration is hard. That doesn't mean the system is bad or that the mission isn't worthwhile.


    Everyone's favorite system - in any industry - is the last one, no matter how much they complained about it when it was in use.

    Leave a comment:


  • leswp1
    replied
    Originally posted by Swansong View Post
    I guess I'm just going strongly disagree on healthcare IT. Some struggle, but many embrace it. Early EHRs were bears, but anything remotely modern (i.e. kept up to date within the past decade) is very good. Implementations vary, obviously, and when organizations half *** it by choosing to use multiple systems, well that's dumb and frustrating. There is only one truly enterprise-level EHR - Epic - but it's expensive. Choosing less expensive alternatives for the hospital itself requires yet other EHRs for ambulatory settings. Do they connect properly? Does data seamlessly flow between them? Maybe... but even then, the EHR itself is fine, it's the interconnectivity that's lacking.


    Regarding SAP... yeesh. Look, it's a decent enough application. The problem, in my experience, (one implementation in last career, and my ol lady is going through one now at her company) comes from half-baked planning and the fact that they're often trying to combine many, many, many sources of data that are an absolute mess. SAP requires discrete data fields for almost everything and if your legacy database combined things... well. Good luck!
    Sorry. All research shows the amount of time entering data and using EHR systems (all) shows the time suck is 4 times as long as it used to be. It has created jobs- scribes, other excess staff, to deal with the extra work load added. I cannot see my Provider one on one because they have a scribe to assist in the cumbersome documentation process (this is EPIC). I haven't seen a Provider who has any idea what is happening with me for at least 5 yrs- I have to fill them in because the info is not available or is so time consuming to find they don't bother and just ask me. This past yr all 3 of my Providers switched to EPIC. All 3 Practices were a CF. Lost data, lost appt reminders, discussions between staff and Providers on where they were supposed to enter data because there wasnt' a spot where they wanted to put it and they can't find previous data.

    Watched the ICU the Nurses take less than 5 minutes to collect the info needed re INtake, OUTput, IV fluids hung/what was left at prescribed interval. They then spent 20+ minutes entering it, having to use multiple windows, redundant steps and documentation and needing to confer with each other. They also were talking about how someone else had entered something in a different place that meant the tracking they needed wouldn't work. This process used to take less than 30 seconds to document in a real chart. (Pretty sure this is EPIC).

    Systems periodically update and lose data when they do. The way the data was entered didn't fit the way people thought it should have been used so doesn't migrate well. None of them take into account the interconnectedness and natural progression of care- there are little modules for everything that need to be opened. It shouldn't take anyone, never mind an ICU nurse, 20+ minutes to document input, output and vital signs after needing to confer with colleagues to make sure they are entering things in the right place.

    If the system didn't change maybe things would improve with exposure and ability to create predictable work patterns. Unfortunately I can't remember the last time I entered a medical setting for myself or someone else, that they weren't dealing with an update or migration that was causing confusion, wasted time.

    This last adventure with FIL les showed me- real time- just how scary the missed info, lack of coherence, lack of detail conveyed and lack of continuity due to disjointed way the records are. If we hadn't been supplying correct info he would be dead.

    Leave a comment:


  • leswp1
    replied
    Originally posted by MissThundercat View Post
    Driving through Rockford, MI yesterday, saw a sign that said "make our city a sanctuary city for the unborn."

    Then again, Rockford/Sparta is so red it's burgundy.
    Gee, does that mean they are going to provide healthcare, feed and house the pregnant women?

    Leave a comment:


  • Swansong
    replied
    I guess I'm just going strongly disagree on healthcare IT. Some struggle, but many embrace it. Early EHRs were bears, but anything remotely modern (i.e. kept up to date within the past decade) is very good. Implementations vary, obviously, and when organizations half *** it by choosing to use multiple systems, well that's dumb and frustrating. There is only one truly enterprise-level EHR - Epic - but it's expensive. Choosing less expensive alternatives for the hospital itself requires yet other EHRs for ambulatory settings. Do they connect properly? Does data seamlessly flow between them? Maybe... but even then, the EHR itself is fine, it's the interconnectivity that's lacking.


    Regarding SAP... yeesh. Look, it's a decent enough application. The problem, in my experience, (one implementation in last career, and my ol lady is going through one now at her company) comes from half-baked planning and the fact that they're often trying to combine many, many, many sources of data that are an absolute mess. SAP requires discrete data fields for almost everything and if your legacy database combined things... well. Good luck!

    Leave a comment:


  • ScoobyDoo
    replied
    Originally posted by FadeToBlack&Gold View Post

    There are three major components of every solution - people, process, and technology. The platform is always the easiest thing to blame.
    True. Very true.

    Leave a comment:


  • dxmnkd316
    replied
    Originally posted by ScoobyDoo View Post

    Perfect. I am going to use this if it's ok.
    Absolutely

    Leave a comment:


  • FadeToBlack&Gold
    replied
    Originally posted by Slap Shot View Post
    It's not my primary role, but I do some consulting and I'm sorry if some of them hurt you.

    Yet if your company feels it necessary to seek assistance perhaps the issue isn't on the consultant's side.
    There are three major components of every solution - people, process, and technology. The platform is always the easiest thing to blame.

    Leave a comment:


  • MissThundercat
    replied
    Driving through Rockford, MI yesterday, saw a sign that said "make our city a sanctuary city for the unborn."

    Then again, Rockford/Sparta is so red it's burgundy.

    Leave a comment:


  • Slap Shot
    replied
    It's not my primary role, but I do some consulting and I'm sorry if some of them hurt you.

    Yet if your company feels it necessary to seek assistance perhaps the issue isn't on the consultant's side.
    Last edited by Slap Shot; 01-01-2024, 10:19 AM.

    Leave a comment:


  • ScoobyDoo
    replied
    Originally posted by dxmnkd316 View Post

    SAP consultants are the blurst. Almost every rollout goes like this

    1. Hire consultants
    2. Plan for 2 years
    3. First roll out is a disaster
    4. Push back dates a year, get informed you're 50% over budget
    5. Second rollout is a disaster
    6. Fire every ****ing one of the consultants
    7. Delay everything 2-3 more years, double or triple the budget.
    8. Attempt to survive the next 5 years
    9. Spend the next twenty years healing scars and PTSD from your employees who went through it and stayed with you
    Perfect. I am going to use this if it's ok.

    Leave a comment:


  • dxmnkd316
    replied
    Originally posted by Kepler View Post

    Welcome to Consulting!
    SAP consultants are the blurst. Almost every rollout goes like this

    1. Hire consultants
    2. Plan for 2 years
    3. First roll out is a disaster
    4. Push back dates a year, get informed you're 50% over budget
    5. Second rollout is a disaster
    6. Fire every ****ing one of the consultants
    7. Delay everything 2-3 more years, double or triple the budget.
    8. Attempt to survive the next 5 years
    9. Spend the next twenty years healing scars and PTSD from your employees who went through it and stayed with you

    Leave a comment:


  • ScoobyDoo
    replied
    Originally posted by leswp1 View Post

    Well, to be fair- it is a self sustaining industry. It creates a disjointed, decentralized, convoluted work stream that reinvents itself continuously in ways that have nothing to do with functionality for the person using it. Add in all the glitches, errors, loss or change of functions with each new 'improvement' and the folks in IT have a guaranteed job. The worker bees get to have increased work load, redundancy, while listening to people tell them the system streamlines, simplifies and allows less errors

    *maybe not true for some industries but the medical side research showing increased work load, decreased productivity and no statistical improvement for outcomes. Now if you are data mining.....
    I agree 100%. The fact that the two careers I have had in my life are both completely irrelevant to creating anything of substance in the World saddens me greatly. Too late to change again now. I just don't have the energy or the wherewithal to change again.

    Leave a comment:

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