From a psychiatrist, partially in response to the article about me in Kaiser Health News, on the travails of health IT.
... In psychiatry we screen for certain medication side effects using a tool called "DISCUS." [Dyskinesia Identification System Condensed User Scale - ed.] In a paper and pen world, we (1) reviewed a single page; (2) circled a score; (3) signed and (4) dated.
In [redacted] EHR, we need to do the following to complete one DISCUS…
DISCUS Completion in [redacted] EHR:
- 1. Log in;
- 2. Acknowledge to do items by choosing “ok”;
- 3. Go to “my to do list.”
- 4. Double click specific date of to do items to complete (this reveals the specific to do items)
- 5. Right click specific patient’s name
- 6. Choose “enter option”
- 7. Review all 3 pages under “assessment” tab (click through each page)
- 8. Then choose “evaluation” tab
- 9. Review “evaluation” (keeping in mind the total score from last page of “assessment”)
- 10. Choose your “conclusion” in item 5
- 11. Add “comments” as indicated (item 6)
- 12. Under “name/ID number” type in the first characters of your last name (or your ID number)
- 13. Select your name
- 14. Go to the bottom under “select physician to notify” and UNcheck your name
- 15. Click “yes” under “is evaluation section complete and ready to be locked?”
- 16. Confirm above choice by choosing “ok”
- 17. Press “submit” button across the top
- 18. Now go back to “my to do list” and you’ll see that the item you just processed above is still there -- double click the same to do item that you just finalized (and processed in item 5 above)
- 19. Then check “reviewed”
- 20. Then press “submit”
- 21. Then press “refresh” and the item will be completed (refresh does not need to be done after each DISCUS)
- 22. For processing of additional DISCUS for a given “sign on," go back to step 3, 4 or 5 (as needed), and repeat.
And this is just the easy stuff.
I'm not a psychiatrist, but I can opine with confidence that anyone who expects human-computer interaction such as this to "revolutionize medicine" is insane.
Perhaps this helps explain city-wide debacles such as this in San Francisco.
Thank You and Good article Are the health IT hyper-enthusiasts inept, or merely insane? this time, hopefully can benefit for you all. see you in other article postings.
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