PAPER and EMR: An Intimate Conversation
Perhaps within a post enchilada and black bean quesadilla dinner dream, but somewhere, I swear, I overheard the following chat, mostly in whispers, very, very late one night …
PAPER: Pssssst…psssssst…hey, you, digi-boy…you awake?
Electronic Medical Record (EMR): Huh? Wha…? Yeh, guess I am. The newbie musta forgot to log out. What’s up, P?
PAPER: I couldn’t sleep.
EMR: Well, no wonder. You get to nap all day long, whenever you want. Some of us get pointed and clicked on all day.
PAPER: Whoa…hold it, pal, I still have my moments of value. You haven’t taken over everything in this joint, yet. Remember, last week when the power went out? Only me, some cloudy daylight, and a few emergency-powered lights were around to keep the patients percolating through the practice. You closed up shop just as fast as your little UPS could shut you down.
EMR: Yeh, well…
PAPER: And, remember last month when your Internet pipe pooped out? Lotta good “Web-based” does you when the road to it gets washed out.
EMR: I know. It does keep me a tad edgy being so dependent upon somebody’s wires or satellites. Still, for as hard as I work and as much as I can do, I think I more than make up for my weaknesses. Criminetly, you can’t even do your work unless somebody’s holding your hand. You’ve never had the common courtesy of letting someone access you from afar.
PAPER: Yeh? Well, your short-term memory doesn’t hold a candle to mine. All I need to do is see something once and it’s mine. Somebody pulls a plug while you’re listening to a long monologue and that info hits the ethers. Whoosh. Vanished. Shoot, you could even forget a whole days’ worth of data should the nighttime backup fail and some zitz hit your RAID.
EMR: Maybe my memory has a few less-than-solid links, but my cousin has this “fail-back” or “fail-over” or “fail-something” thing that keeps his memory even sharper than yours! Everything that goes into him is retrievable from moment one; you ever try to translate some of that scribble jibberish you call “data?”
But, that is so like you…mentioning the unlikely as if everything should be based upon that. Remember the fire of ’04? Your short-term memory didn’t do anybody any favors that day. Hector’s pup, even your long-term memory was a crispy little critter. Me? A new PC body and my recall was total, complete.
PAPER: OK, fine, I’m sorry. I didn’t wake you to start a squabble. It’s just that all I seem to hear these days is about how wonderful you are, about how you are the future. It has me a little concerned for the practice.
EMR: OK, I’ll bite. How so?
PAPER: Don’t get me wrong; you’re a heckuva nice guy. You’ve got loads to offer and are just built for the 21st century. I know I can’t hold a candle to your overall prowess. But, I’ve done this for years, you know. I remember when we used to always see 30, 40, 50, and sometimes more, patients per day. Sick folks needed our help and we were there to provide it – when they needed it. Now, since you’ve taken over most of the grunt work, we’re lucky to eke out 25 visits…on a good day.
EMR: IT’S NOT MY FAULT! I CAN FLY! It’s these pokey point-and-clickers and those two-fingered typists who are so infuriatingly slow. You know how fast I can run with a full load!
PAPER: I know, buddy, I know. But, regardless of who’s the rate-limiting step, the practice is slowed down; less people are getting cared for and the Accounts Receivables fellow said the cash flow has taken a real hit. I’m worried.
EMR: So what do you think we should do? (Though I’m not sure we have a say in the matter.)
PAPER: Maybe if we work together, maybe if we get them to incorporate a part of me with a part of you…at least for a while until they can get their skills and this whole workflow readjustment thing under control…
Honestly, I know my days are numbered. Shoot, when you’ve been around for a couple thousand years, I’ll bet you won’t look so spry. But, still, while I still can, I want to help. I care about these issues, this practice. I want to help, as best as I can, for as long as I can. I think I still have a few useful services you haven’t outpaced, you know.
EMR: I know you have, Paper, old pal. Maybe we can work together to help the practice find a better middle ground. Use some of your familiarity along with my connectivity to keep things snappy while we work on your retirement plan. Think we could get the organics to listen?
PAPER: Who knows? They’re kind of trendy, faddish, even. Getting them to think as clearly as you and I may be nigh on impossible.
EMR: (Sigh) Don’t I know it…ssssssssshhh…I think I heard footsteps.
From the (dreamy) trenches…
“Coming together is a beginning. Keeping together is progress. Working together is success.” – Henry Ford
Dr. Gregg Alexander is a grunt-in-the-trenches pediatrician and geek. His personal manifesto home page…er..blog…yeh, that’s it, his blog – and he – can be reached through http://madisonpediatric.com or firstname.lastname@example.org.