Our hospital patient care system was sold to the management with a hint that they would collect their money faster and in greater quantity. In the minds of clinicians, the core business of the medical center is patient care with revenue as the byproduct but too little attention was given to the clinical capacity of our Electronic Medical Record which has been a struggle to maintain. My clinical notes are now pages of cut & paste and carry over from last time. The designers had the saichel not to put spell check or grammar corrections into the doctor's note writing. I and many others have learned to leave the grammatical errors in the text as the only way a recipient reader can wade through a multipage report and find which few sentences came from the doctor.
Next week rolls out an updated version. It would be hard to create a downgraded version of NextGen. In preparation all users had to take an on-line course and a three hour lecture course to figure out how to use it. I didn't really figure out how to use it as much as I learned what it could do. If you were to ask me to add a series of fifteen 3-digit numbers I could do it accurately in a couple of minutes, not so much because I attended a few blackboard sessions in fourth grade but because there was a certain amount of drill and experience that accrued as a user. My many complaints about prescription writing, scheduling tests, creating lists of often used medicines, replacing inane pharmacy defaults with defaults of what I might actually ask somebody to take, all of these were always there but nobody really showed me how to use them the best way or checked with me in two years to see how it was going. So while I am in California later this month without the patients coming at me, I will try to set a time aside to customize this in a way that makes it more useful. The notes will not get more professional as a result but with a little luck I will be able to look at the patients more and the screen less while we occupy the exam rooms.