Dr. Vogt shared an article with me that caused me to look at a process that I’ve been an advocate for from another perspective.
We all know the dangers of texting while driving and there’s now a compelling argument that typing while doctoring may be just as dangerous.
Multitasking is dangerous and texting while driving increases your risk of a crash by 23%. The use of a cell phone while driving reduces concentration by 37%…
Is it possible that physicians typing into an electronic record can create a similar distraction for the physician and pose a risk to patient care?
I’ve talked a lot about meaningful use and the push for health care providers to adopt the use of electronic medical records. One of the requirements of meaningful use is the adoption of CPOE or Computerized Physician Order Entry. CPOE requires the physician to direct attention to a keyboard as opposed to a patient. The theory behind CPOE is sound and CPOE should reduce medical errors because nothing is lost in translation because the physician ordering a medication or service enters the order independently and there’s no “middle man” thus reducing the margin for error.
Prior to CPOE a physician would either handwrite or give a verbal order for a medication or service and that usually occurred immediately after the patient encounter. CPOE allows the order to occur electronically in the presence of the patient. It’s not possible to look at a keyboard and a patient at the same time and there’s no question that a physicians “data input” time increases with the use of CPOE.
Like all new processes refinement will occur overtime and the process will become more efficient but for CPOE to be successful and best for the patient it may be necessary to include other members of the health care team in the process. Providing nurses, medical assistants and other health care providers the ability to perform CPOE may allow the physician more time to spend with the patient and reduce distractions where attention should be focused, on the patient.
A physician is valued for his or her ability to think and act. A physician must evaluate the information at hand and determine the best course of action for a patient. A physician isn’t valued for his or her ability to type. Any type of distraction poses a risk for the patient. One of the goals of the electronic medical record should be to reduce distraction and provide support to the physician by helping the physician make a sound, timely decision based on the information at hand. The benefit of the electronic health record is that it puts more information at hand, the downside is that information overload can become a distraction as opposed to an asset.
CPOE is a requirement and there are financial incentives for complying and penalties for not complying so to some degree we’re stuck playing the game. Hopefully overtime the rules will be modified to assure that the value of the electronic medical record continually evolves to provide additional value to patient care.
Electronic medical records should make patient care safer and more efficient, we just need to be sure the processes associated with the use of electronic medical records becomes efficient as quickly as possible.