Dr. Cranquis' Mumbled Gripes

I'm an American physician who works in an Urgent Care clinic. I see lots of stupid or funny things that people do with-and-to their health. I cope by mumbling under my breath (and then posting about it on this pseudonymous blog). Thought you might be interested.

(Disclaimer: Questions related to medical topics will be answered to the best of Dr. Cranquis' (and Google's) knowledge, but the internet-delivered wisdom on this blog CAN NOT AND SHOULD NOT SUBSTITUTE for your Real-Life Doctor's personal attention + examination, and your own common sense too! If you think you're having a medical emergency, hang up and go email 911. The author of this blog takes no responsibility for any medical, relationship, scholastic, financial, or other decisions you may make based on information found in this blog.)

Blogs I Follow

Electronic Charting

Hey Doc-
What are your thoughts on electronic charting? is there a system that you consider the best? (ochin, practicefusion) Does the electronic charting help or hinder your day?

Ok, this is a messy topic. I’ve written quite a lot about EMR (Electronic Medical Records) already, and those posts can be summarized into:

It’s great for keeping track of doctor-shopping drug-abusing patients
The e-prescribing portion has greatly reduced medication errors by removing doctor-handwriting from the equation.
Most EMR software sucks and is not designed to be friendly for doctors (I’ve used two systems in my career, Cerner Powerchart and Epic Smart Chart — Cerner blows, Epic toddles along)
The US “Healthcare ~~Insurance~~ Reform” bill requires all docs to start using EMR, but this will create more problems (particularly, contributing to the doctor shortage) without solving the real issue (skyrocketing overuse of expensive medical tests and interventions + grotesque under-reimbursement for medical services)
The plethora and disparity of EMR systems does nothing to improve communication between doctors in different groups/hospitals.

Go read those posts for more details.

As for whether EMR “helps” or “hinders” my day: OVERALL, it helps… with the following caveats:

As long as whatever computer glitch-of-the-day is simple enough for me to solve on my own (using my 5+years of experience in working with this particular glitch-prone EMR system which acts up at least twice a week), without having to spend 5-20 minutes on the phone with tech support….
As long as the wireless signal doesn’t decide to randomly drop out…
As long as the printer doesn’t get jammed and the nurse keeps it stocked with paper…
As long as the fax machine is working at the pharmacy receiving my e-prescription…
As long as the computer isn’t running slowly because of the latest Windows System update bogging things down…
As long as the lab or xray report doesn’t get sent to the wrong physician’s inbox, requiring me to hunt it down…
As long as I can read the handwriting on the scanned-in note from the patient’s ER visit or specialist consult (many of those “outside” locations don’t use EMR, so we still have to decipher handwritten notes!) …

Then it does help. But let any of those factors go wrong, and you’ll hear me cursing the system’s name to the skies as I reach for my trusty paper prescription pad.

***Pending Cranquis-Mails: 9; Inbox: Closed***