Rep Retirement Lodge 199 - Dumb Poll of the Month

[leswp1]

Re: Rep Retirement Lodge 199 - Dumb Poll of the Month

We have a putrid PK. Had a 2-0 lead and gave up 3 PPGs against a team (UVM) which had scored 4 all year.

We just have moments of narcolepsy where we forget intensity and urgency.

 

[leswp1]

Re: Rep Retirement Lodge 199 - Dumb Poll of the Month

Good Afternoon Lodge!

 

[Ralph Baer]

Re: Rep Retirement Lodge 199 - Dumb Poll of the Month

Good Afternoon, leswp1!


Good Afternoon to the rest of tLodge!

 

[FlagDUDE08]

Re: Rep Retirement Lodge 199 - Dumb Poll of the Month

Good Evening Lodge!

Didn't notice there was a new pole out...

 

[FlagDUDE08]

Re: Rep Retirement Lodge 199 - Dumb Poll of the Month

FHT. Ferris gets their first road win. Yeah. Not happy. Week was going good, and starting this afternoon, when my local brewery boot (yes, boot as in Das Boot) dropped and broke, the day has gone downhill. Goddammit.

Wait a sec... when'd you change your name, Brenthoven? This is going to make PotY really complicated again...

 

[The Rube]

Re: Rep Retirement Lodge 199 - Dumb Poll of the Month

Wait a sec... when'd you change your name, Brenthoven? This is going to make PotY really complicated again...

A week or two ago. Wanted to sync with my other social media, and keep the name consistent.

 

[MarkEagleUSA]

Re: Rep Retirement Lodge 199 - Dumb Poll of the Month

Good morning to tLodge!

 

[Ralph Baer]

Re: Rep Retirement Lodge 199 - Dumb Poll of the Month

Good Morning, Lodge!

 

[Scarlet]

Re: Rep Retirement Lodge 199 - Dumb Poll of the Month

Did rep disappear for anyone else? I went to the Notifications link in the upper nav to check my rep - les. I was trying to get your number - and all that was there were those stupid friend requests.

Wishing you all a Happy and Safe New Year! Dad still here in rehab, having a family meeting today with all the folks here. Hoping to get a more definitive answer about his stay here. Had a bad night last night. His anxiety is....I just can't even figure out what's going on. les - can you Facebook Message me your cell? I do want to reach out to you. I need some advice.

 

[Ralph Baer]

Re: Rep Retirement Lodge 199 - Dumb Poll of the Month

Did rep disappear for anyone else? I went to the Notifications link in the upper nav to check my rep - les. I was trying to get your number - and all that was there were those stupid friend requests.

Wishing you all a Happy and Safe New Year! Dad still here in rehab, having a family meeting today with all the folks here. Hoping to get a more definitive answer about his stay here. Had a bad night last night. His anxiety is....I just can't even figure out what's going on. les - can you Facebook Message me your cell? I do want to reach out to you. I need some advice.

Try the Settings link at the top. I only get a link to Rep from Notifications when I get a new Rep.

 

[Swansong]

Re: Rep Retirement Lodge 199 - Dumb Poll of the Month

I am just a 'little' hot under the collar about EMRs. IMHO the mandate sent us into the dark ages. Less accessible information, more compartmentalized with no interconnectivity. I swear after the EMR seeing a new patient was like seeing someone in an ER- no info, rely on the pt to tell you info and hope you get it all.

Serious question- Curious how this solves portablility. None of the EMRs we had communicated with anyone else so we had to print out stuff to send (or we got printed stuff). Complete drek. We used to call the previous practice and ask specific questions and the other practice could look it up and give us answers which we would then manually enter. Dealing with the pts in the NH the students just throw up their hands. Inches high records, no way to make any sense out of them except sifting thru manually hoping to find what you want. Not linear, frequently disjointed. I know what I am doing and it is close to impossible to find stuff. Honestly the paper is 100% easier to deal with than trying to make sense out of a pt record. Exceptions- if you ask it to print out immunizations.

I wasn't sure how to reply to this because what you're describing absolutely doesn't sound like Epic. And then...

IIRC, Epic wasn't the EMR that les had to use.

And now it makes sense.

The previous generation of EMRs (ECW, Athena, Centricity, Meditech, etc.) were woefully inadequate with data sharing. What you're describing, Les, sounds like a bunch of places using ECW. Every practice had its own instance, and ne'er the twain shall meet.

Obamacare, for all its warts, helped by taking a big hammer to this problem and requiring connectivity. Epic came along. Athena got better. Cerner came along. And suddenly the HL7 standard was in real use and systems could talk to each other. For example - if you go to almost any hospital in eastern mass, they're on Epic and can very easily query patient data from the other Epic shops. Patient's doctor's office on Athena? Well, it's a bit tougher but my hospital is about to go live with a data archive project designed to pull legacy data from each practice into the Epic record (a monumental undertaking, I can't wait to not have to work on it anymore).

Most of the complaints with Epic are that it's too workflow-based, and providers and other staff that came from paper or other EMRs suddenly had to rethink their basic daily tasks. An order triggers a scheduling request. A scheduling request triggers an appointment, an appointment triggers pre-visit charting, etc. If the doctor/NP/whomever didn't put in that referral order, nothing else can happen. A lot of our providers were ridiculously obstinate and refused to do this, and blamed the system.

Is this the best way to do it? I have no idea. But from what I've seen from the previous generations of EMRs, it's a monumental step in the right direction. I'm hopeful that the next generation brings another substantial leap forward and we can kind of go back to that patient experience where the provider is actually paying attention to them and not clacking away at the computer.

 

[ARM]

Re: Rep Retirement Lodge 199 - Dumb Poll of the Month

Hey Lodge. I hope your 2018 was all that you hoped. If not, the good news is that it will only disappoint you for a few additional hours.

I wish you all a happy 2019!

 

[mookie1995]

Re: Rep Retirement Lodge 199 - Dumb Poll of the Month

s’upp y’all

Getting ready to head out into the Wild West canals for Amsterdam nye

If mookie catches a firework in the butt and blows up, well it’s been nice knowing all y’all

 

[Ralph Baer]

Re: Rep Retirement Lodge 199 - Dumb Poll of the Month

Note to self, don't plan on eating lunch near the Capital One Arena when the Caps have an afternoon game. (Actually it probably went faster than usual because the staff wasn't lackadaisical.)

 

[Swansong]

Re: Rep Retirement Lodge 199 - Dumb Poll of the Month

s’upp y’all

Getting ready to head out into the Wild West canals for Amsterdam nye

If mookie catches a firework in the butt and blows up, well it’s been nice knowing all y’all

That's.... hot.

 

[FadeToBlack&Gold]

If mookie catches a firework in the butt and blows up, well it’s been nice knowing all y’all

So that's what the kids are calling it these days...

 

[Hammer]

Re: Rep Retirement Lodge 199 - Dumb Poll of the Month

Closed out 2018 with a family funeral. My dad's cousin was working out in his basement on Christmas Eve and suffered an aortic aneurysm. His funeral was this morning. 54 years old.

Full Catholic mass for the funeral. That side of the family is still VERY Catholic, although his mother is the last of her generation. At 87 and wheelchair bound, I don't think there's much time left on clock for her. Today I realized that not only am I not very religious at all, I also really dislike Catholic masses. I think I understand why my dad and his siblings left the Catholic church many years ago.

It's also just above freezing out and raining holy hell. Last night I was asked to be a pallbearer, as my dad's uncle had clearly not figured out that part of the service as we were at the funeral home and he was asking people. Thankfully the cemetery is right across the street from the church. Even better when the funeral home handling the arrangements ran the thing like a chinese fire drill.

 

[St. Clown]

Re: Rep Retirement Lodge 199 - Dumb Poll of the Month

Closed out 2018 with a family funeral. My dad's cousin was working out in his basement on Christmas Eve and suffered an aortic aneurysm. His funeral was this morning. 54 years old.

Full Catholic mass for the funeral. That side of the family is still VERY Catholic, although his mother is the last of her generation. At 87 and wheelchair bound, I don't think there's much time left on clock for her. Today I realized that not only am I not very religious at all, I also really dislike Catholic masses. I think I understand why my dad and his siblings left the Catholic church many years ago.

It's also just above freezing out and raining holy hell. Last night I was asked to be a pallbearer, as my dad's uncle had clearly not figured out that part of the service as we were at the funeral home and he was asking people. Thankfully the cemetery is right across the street from the church. Even better when the funeral home handling the arrangements ran the thing like a chinese fire drill.

While I'm one who would ever be confused for a believer, the ritualistic structure and tones of the mass make sense to me, especially the full "bells and smells" masses. The Catholics I know (my mom's side of the family is very devout, as is my wife's), seem to be big into their rituals and the pomp when it comes to events.

 

[leswp1]

Re: Rep Retirement Lodge 199 - Dumb Poll of the Month

Did rep disappear for anyone else? I went to the Notifications link in the upper nav to check my rep - les. I was trying to get your number - and all that was there were those stupid friend requests.

Wishing you all a Happy and Safe New Year! Dad still here in rehab, having a family meeting today with all the folks here. Hoping to get a more definitive answer about his stay here. Had a bad night last night. His anxiety is....I just can't even figure out what's going on. les - can you Facebook Message me your cell? I do want to reach out to you. I need some advice.

Sorry!!! I didn't get on my laptop until just now. I FB you my #. I will be around most of tomorrow We have company coming at some point in the afternoon.

I wasn't sure how to reply to this because what you're describing absolutely doesn't sound like Epic. And then...


And now it makes sense.

The previous generation of EMRs (ECW, Athena, Centricity, Meditech, etc.) were woefully inadequate with data sharing. What you're describing, Les, sounds like a bunch of places using ECW. Every practice had its own instance, and ne'er the twain shall meet.

Obamacare, for all its warts, helped by taking a big hammer to this problem and requiring connectivity. Epic came along. Athena got better. Cerner came along. And suddenly the HL7 standard was in real use and systems could talk to each other. For example - if you go to almost any hospital in eastern mass, they're on Epic and can very easily query patient data from the other Epic shops. Patient's doctor's office on Athena? Well, it's a bit tougher but my hospital is about to go live with a data archive project designed to pull legacy data from each practice into the Epic record (a monumental undertaking, I can't wait to not have to work on it anymore).

Most of the complaints with Epic are that it's too workflow-based, and providers and other staff that came from paper or other EMRs suddenly had to rethink their basic daily tasks. An order triggers a scheduling request. A scheduling request triggers an appointment, an appointment triggers pre-visit charting, etc. If the doctor/NP/whomever didn't put in that referral order, nothing else can happen. A lot of our providers were ridiculously obstinate and refused to do this, and blamed the system.

Is this the best way to do it? I have no idea. But from what I've seen from the previous generations of EMRs, it's a monumental step in the right direction. I'm hopeful that the next generation brings another substantial leap forward and we can kind of go back to that patient experience where the provider is actually paying attention to them and not clacking away at the computer.

Not Epic. Was on Medinotes, ECW and as I left they were forcing a change over to Cerner (universally hated).

What I don't get and no one seems to answer this= why must the providers adhere/adjust to a system invented by people who do not practice medicine and have no care for what works for Provider / nurse/staff flow? The way most people practice came about for a reason. It was took into consideration how decisions/diagnoses are made, it was efficient, it worked and it prevented errors. Now they invent this new system, insist that we do things to adjust to the system that does not work if using a decision tree, creates more work, is less efficient and is more prone to errors. Why can they not 'electrify' the current systems that are, for the most part, functioning well?

Well, I know the answer is because it isn't about any of those things but about keeping insurance co happy and able to mine data but it still aggravates. This isn't just about rethinking daily tasks. The thinking is structured the way it happens for a reason. Medicine is NOT linear. There are complex decision trees. You need to be able to go in a few directions at once, adapt/respond to what is happening. This is utterly impossible when trying to order or document in an EMR. Some of the young Docs are useless when you throw them any kind of non-linear thing because they need everything to fit into the false linear narrative of an EMR. For complicated notes I would end up hand writing the note first, then go thru entering the multiple components as well as free handing large portions in the EMR. There just was no little box to put some of the info that was important and gave context.

And reading these posts/responding just reinforces the reason I would never return to practice unless I could do it paper based/insuranceless. Sadly I know I am not alone. In the last yr 6 of my friends/colleagues have also pulled the 'chute. A few more are actively working to get out. In my area we are having a wicked shortage of Primary care providers because they are all leaving to do things other than medicine. (fun factoid- 64% of Primary Care providers are experiencing burnout. One of the major reasons cited was EMR)

 

[FadeToBlack&Gold]

Re: Rep Retirement Lodge 199 - Dumb Poll of the Month

especially the full "bells and smells" masses

Bells during the consecration? Haven't seen that in 20 years, and even then that was at a very rural parish where my mom had to explain it to me (she hadn't seen it in ages, either). Incense, yes of course, during a High Mass.