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Tech Thoughts from a Hospital Bed

Scott Mace, for HealthLeaders Media, July 1, 2014

After emergency surgery, a few observations on the clinical narrative, the value of the medical record in any form, and the small miracles that make our healthcare system hum.

On Monday, June 16, I was preoccupied, preparing to head to the annual Computer-Physician Symposium run by AMDIS in southern California. But I had a scheduled doctor's appointment to tick off my to-do list first.

Fortunate thing.

A block from my doctor's office, as I was crossing a street in Alameda, California, I felt like my guts had been sliced open. I doubled over in pain and, with effort, continued to my doctor's doorstep.

In the exam room, my doctor found my abdomen distended and me generally feeling like I wasn't going anywhere but the emergency room.

The staff called me a taxi, and 15 minutes later, I was at Alameda Hospital, gladly accepting a wheelchair ride. The pre-op history report told the story: "CT scan shows acute appendicitis."

So, that night, into surgery I went. Initially, the surgeon detected "no sign of perforation" and I remained "alert and oriented" going under anesthetic. But, once inside, he found a "gangrenous appendix with perforation" and what should have been a 30-minute procedure took two and a half hours.  It sounds just about as awful as it felt.

[If you're really curious, here's a video of a laparoscopic appendectomy of a ruptured appendix.]

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2 comments on "Tech Thoughts from a Hospital Bed"


anita panganiban (7/2/2014 at 2:49 PM)
Hello! I hope you are recovering nicely, and I had the same experience. On my way to a conference, ER for a ruptured appendix, and my road was a longer one, complications, etc. Software driven care and patient room technology were of great interest to me! A healing touch, extra care, and advocacy on behalf of the patient is always personally driven, and those things mean the most. Best of luck in your recovery! Anita

Michael Jon Cohen M.D. (7/2/2014 at 2:41 PM)
I enjoyed reading your post. I would love to hear your thoughts on the clinical narrative as presented by the electronic medical record. From my standpoint and the overwhelming majority of my colleagues, the EMR is merely a data dump. Whereas a patient's course could previously be summarized in a succinct daily quarter page progress note, a day in the life of a EMR record is often many pages, and the reader has to search to cullout the important entries. EMR has obviously made some communication easier (no lost paper charts). It has failed miserably however in that it does not tell a story, has championed documentation over all, and with its lack of interoperability, has not lessened the cost of care.