Tuesday, April 30, 2013

Keyboarding Our Way Through Health Care/Obama Care.

A few weeks ago, an old friend of my late father was describing his latest hospital stay. He kept talking about all kinds of new changes. He also talked about how healthcare practitioners spent less time with him than in the past. This individual had been hospitalized several times in the past two years, so I consider him to be more or less an expert patient on this subject.

This weekend I began to understand his frustration following an injury to my mother-in-law.  She slipped and fell early Sunday morning. She found herself in intense pain and unable to get up. Because of prior harassment from her daughter, she pulled out her cell phone from her pocket and dialed 9-1-1. At age 94, and remarkably self-sufficient up to that moment, she directed responders on how to enter her house and where she was located.

She was transported to a major hospital which is constantly expanding, located in the western suburbs.  A quick x-ray revealed a fractured femur, requiring surgery in the form of a partial hip replacement and insertion of a rod. Surgery was finally performed at 7:30 p.m. last night. Changes in our healthcare system created by the soon to be implemented "Obamacare" made things somewhat complicated. Time frames for tests and care are now expanded. I began to understand the complaints I had heard a few weeks ago.

Hospitals and healthcare providers have been busy making changes to accomodate the implementation of "Obamacare." I call it "Obamacare" because the President seems to like the nickname of the Affordable Care Act.

With my mother-in-law, hospital staff had just started a new "paperless" patient chart system the day before. No doctors entering the room holding a file and thumbing through pages. When I arrived, I noticed doctors and nurses seated at workstations, staring at computer screens and typing. And typing. And typing some more.

When I finally asked about implementing a voice dictation like system for doctors and nurses tied up typing, I was informed that patient privacy issues still had this idea under review.

Tests were ordered by typing. Routine checks of her temperature and blood pressure were performed after a sequence of typing. The results were entered after the computer found her chart and called it up. Access to each page required a series of passwords. A blood test order took 20 minutes to type and enter. The patient's file was accessed through bar coding, numbering and other devices I see in the local grocery or pharmacy. And the doctors and nurses were spending more time at their desks or at a computer screen in the patient's room, than they were spending with their patients.

When finally admitted and transferred to a room, a station filled with computers was right outside her door. This station was again filled with doctors, nurses and assistants staring at computer screens and typing. And typing. And typing some more. A debate broke out between nurses when a bar coded IV bag did not register in the patient record, in spite of multiple repeated sequences of scanning the wrist band bar code, and then the IV bar code.

Surgery was delayed as a pre-surgical checklist could not be located in the electronic patient chart. When located, more tests were ordered.

Electronic patient charting was sold as an idea to save money as part of the extensive healthcare reforms  anticipated through "Obamacare." And yes, money will be saved when one considers storage fees of paper files. Nurses like the idea of scheduling medications through the system, but then find themselves falling behind as they access the system and type. And type. And type some more. Several nurses and doctors did admit that their time with patients were being compromised by this system, which requires attention. They also admitted that the time patients sit in rooms unattended has increased while they type. And type. And type some more.

What I witnessed so far was a more impersonal system of healthcare. "When can I see the doctor?" and "When will they tell me what is going on?" were two questions repeated over and over by the patient.

While those questions were being asked, doctors and nurses were busy typing. And typing. And typing some more. As an attorney specializing in work injuries, I await the next wave of carpal tunnel injuries from the constant keyboarding in hospital care, so maybe I shouldn't be all that concerned about electronic patient files. I should be preparing for future injury cases.

Change for the better?  Somehow I still feel something is missing here. In the meantime, I'm heading back to my car for another hospital visitation.  And I'll be watching them type. And type. And type some more.

1 comment:

  1. Perhaps future requests for medical records will have to include their bar code....