You know those people who say they'd miss having ink stains on their fingers from reading print newspapers? Or who say the experience of reading a book on a Kindle, Nook, or similar device just isn't the same as opening up a paper book? Well, there's a part of me that agrees with them. But there's a part of me that also thinks they're full of it.
And as soon as someone gives me a free e-reader or iPad, I'll let you know whether or not I'm right about that.
Something similar is happening with physicians across the country. Docs complain that they have to enter information into the computer. They rail against change and moan about workflow and claim they have no idea what buttons to push to pull up their patients' electronic medical record.
But once they start using electronic documentation and have had enough time to see the benefits, suddenly they'd never go back to paper records.
"I used to hate doing discharge summaries," says John Umekubo, MD, medical director of clinical informatics at St. Mary's Medical Center in San Francisco. "Now I don't mind it because it's so fast and I think I'm doing a good job. I'll never go back to handwriting. It's just too painful. I think that's universal—people who have converted to electronic will never go back to handwriting."
St. Mary's has employed a number of solutions to address its handwriting legibility issues since 1990, when they were cited by the Joint Commission for it. And, yes, they started with good old paper.
The organization identified the worst handwriting offenders and asking them to print their notes in block letters. Have you ever tried to write anything in block letters other than the words "YARD SALE"? There's a reason busy docs scribble in cursive—it's a lot faster than printing, let alone block printing.
After that, the organization developed some homegrown word processing templates with some fields already filled out. Docs could fill in the blanks from their computers in neat Times New Roman 12 point type. Unfortunately, the documents weren't easily secured—and physicians weren't exactly thrilled with the idea of typing in passwords every time they created, opened, or closed a document. The idea of printing in block letters was starting to look pretty good.
That was in the late 90s. Finally, along comes the electronic medical record. Pre-populated fields, printouts as neat as a pin, and more secure storage than a "My Documents" folder.
The funny thing is that the notes were so legible that everyone could read them—and could clearly see that the actual content of the notes wasn't particularly stellar—in part because physicians were cutting and pasting chunks of text over and over into document after document.
So how did St. Mary's solve the problem? With evolving technology that combines speech recognition and pre-filled templates and that's integrated with medical records—it's automated documentation of a kind not possible nor imagined back in the 90s. You can read more about it—as well as the potential future of electronic notes—in this month's HealthLeaders magazine story: Speaking of Solutions.