I have a colostomy, about 1" opening, and for 8 years I had no problem with my pouches. Then for 3 or 4 months I can't seem to have a bag on for more than a day, and there is leakage. What is deep convexity and should I have different kind of pouches that have a deep convexity? Would that help? Thank you.
EMR: Patient Perception
- Mon, 8/8/11 - 1:46pm
- 7 Comments
- 4772 reads
Over the past year, I have had several encounters with physicians using their (very recently implemented) electronic medical record software.
I am not impressed.
My immediate reactions were 1) This is distracting and impersonal, and 2) Hey! I can play this game, too!
With regard to Number 1, here I am, obviously not feeling great, and here you are, playing with your laptop. Once we share the usual pre-work-up pleasantries, you barely look at me, preoccupied/frustrated with the idiosyncrasies of your (albeit new) gadget. I have to wait while you figure out the problems in accessing the proper screens, interrupting my flow of commentary about what is wrong. Thankfully, both physicians eventually set the computer aside for hands-on examination and thorough discussion, but by now I’m feeling a bit off-put. This is not the best situation for a patient who tends to play down symptoms and protect herself, her loved ones, and even sometimes her doctor from having to deal with medical issues.
With regard to Number 2, I feel the EMR can thwart diagnostic thought processes much the same way a calculator removes the need for students to learn their arithmetic facts. I completely appreciate the need for checklists and algorithms. The new system takes away some of the guesswork, I suppose, and ensures that harried clinicians do not miss something. I’m also assuming it provides diagnostic codes as well. But where is the intuition? Where are the clinical assessment skills? What happens if my symptoms don’t fit the menu? Like Mr. Holland and the hesitant clarinet player, I want to pull the sheet music out from under and tell my docs just to “Play the sunset.” You know this stuff. If physicians become too drop-down dependent, this new system seems like a fast track to getting diagnostically rusty.
What’s more disconcerting is my belief that I could reach a pretty accurate diagnosis if I, too, had prompts along the way. This is worse than all the self-diagnosing I do courtesy of webMD. I know, being the editor of this journal and all, that I take more of an interest in things medical than the average person. I am all for the patient-clinician partnership. But there is something to be said for attributing a little more knowledge and authority to my practitioners.
I’m sure EMRs will become commonplace, accepted, and utilized to the best interests of all concerned. But I’m not so enamored right now. Just sayin.’
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Great observations. Many medical practices like to tout themselves as being on the “cutting edge” when it comes to technology but may be resistant when it comes to implementing EHR. But patients are becoming more sophisticated when it comes to the integration of technology into their lives, and having an electronic practice may be an expectation. I've recently read a very interesting article found by http://byfiles.com saying that patients believe EMRs bring accuracy to their records. I tend to agree to that.
Reply to this comment »I don't think the EMR is a bad way to go. It gives practitioners the ability to communicate more thoroughly than before and stops the problems of "I can't read what this person wrote." From a nursing perspective I like EMRs. Are there issues with them... sure but they are not insurmountable and are no more numerous than the issues associated with paper charts. I mean how frustrating is it for the clinicians to grab the chart and realize something fell out and now is lost or put back in the wrong spot or even the wrong chart.
Reply to this comment »In response to the lack of interpersonal communication, those who were good at it before remain good at it and those who lacked still lack it. The only difference being is now they 'hide' behind the computer instead of working to manage their lack. EMRs are here to stay and I for one say thank goodness.
Tony RN
great comment
Reply to this comment »Our clinicians feel your frustration and hear your words! Jobs we used to do in short time now take longer as we repeatedly point and click the same answers to move on to the next screen, taking our focus from the patient to the computer. Physicians are accustomed to dictation and great notes were produced that told the story. Today we "propagate" and "tag" onto a note that is preset by the computer. Evan worse is when the computer servers fail...we cannot access your history; the chart is the computer. Sad we have become an electronic driven society ....
Reply to this comment »Try reading an assessment, diagnosis and progress note written out in long-hand!! But I wholeheartedly agree with the concept of patient first, computer second.....Electronic Medical RECORD...not DOCTOR! Do the job and make your notes in the storage unit!
Reply to this comment »My recent experience with a new implementation of a EMR shows a different picture than what is presented here. EMR's offer computerized DOCUMENTATION and not computerized diagnostics. There are no "Diagnostic drop downs" to be had. Perhaps some user learning curve frustration but these are documentation systems that still require a practitioner to assess and evaluate the patient. I think this article poorly represents what a EMR system actually does.
Brian, RN
Reply to this comment »How accurate this article is.
Reply to this comment »Using the computer to do our notes in front of our patients for the "much needed electronic billing" requirements has driven our professionals in the health care field to follow a robotic, impersonal, lack of communication skills, writing skills, and use of clinical skills. Our patients now will only know how to communicate to each other through advanced technology. We will all just lose the human contacts that go with the normal human communication, caring, and eye contact. Now, the use of the computer screen will prevent eye contact, sensible verbalization between patient and doctor, nurse, or therapist, and just the ability to touch someone's hand. The side effects of using the computer will just cause, eye strain for the operator, frustrated patients not learning what they need to learn because the operator is too busy to get the information into the computer, and the reason for the problem that brought the patient in to the office or with the health personal will probably be overlooked and not addressed. How our field of health care, understanding our patients, caring, and teaching our patients is changing.
Just a thought as I must get back to the computer to still write the needed notes/documentation.
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