I’m not a fan of the current state of Electronic Health Records (EHR), also known as Electronic Medical Records (EMR). Particularly in acute care, the computer keyboard and screen have no place between an anesthesiologist and his patient, an emergency room physician and his patient, an ICU doctor and his patient, or an ICU nurse and her patient.
In a past column I identified the EHR as the most overrated advance affecting anesthesia practice in the past 25 years.
ZDoggMD expresses similar sentiment in his powerful and humorous You Tube video An EHR State of Mind, in which he raps about Electronic Health Records to the tune of Jay Z’s and Alicia Key’s hit single An Empire State of Mind.
ZDoggMD is a former Stanford physician known for his music videos, parodies, and comedy sketches regarding contemporary medical issues and work in the medical field. ZDoggMD is played by Dr. Zubin Damania, CEO and Founder of Las Vegas-based Turntable Health. Dr. Damania attended UC Berkeley in the early 1990s, followed by medical school at UCSF and residency at the Stanford University School of Medicine.
Check out his website at http://zdoggmd.com. Links exist to multiple equally funny satiric videos. You’re sure to be entertained.
I agree with him that the current cumbersome EHRs come between doctors and patients during hospital care. My criticisms include:
- Different EHRs at different hospitals are unable to communicate with each other.
- If you work at different hospitals with different EHRs, you have to be trained and retrained in multiple EHR platforms.
- With an EHR it takes at least 5 clicks to chart “atropine 0.4 mg.” In the past with a paper record you would merely write “0.4” on the atropine line.
- Nurses consistently have their backs to patients as they type, type, type data into computer terminals. In an operating room, the circulating nurse’s job is analogous to that of a court reporter/stenographer. Florence Nightingale would have had a stroke.
- As ZDoggMD points out in his video, the current EHR is a “glorified billing platform with some patient stuff tacked on.” Hospitals spend hundreds of millions of dollars to install the EHR, and then tell us that the EHR will help them bill and collect money at a superior rate. The economics don’t add up, and have nothing to do with patient care.
- With an EHR, instead of writing a pertinent note at each patient encounter, health care providers copy and paste previous notes, altering the minimal differences at each encounter. This habit makes it difficult to ferret out the pertinent information in, for example, a six-page copied template.
ZDoggMD challenges us as healthcare providers. On his website he writes, “We on the front lines of healthcare need to stand up and demand that our organizations, government, and tech vendors stop letting the unintended consequences of legislation and technology wreck our sacred relationship with patients while destroying our ability to do what we do without having to tell our kids to stay as far away from medicine as they can. Great technology [insert Steve Jobs fanboy comments here] can be the glue that connects us…”
Indeed, I wish Apple Computers would create an EHR which was as intuitive and easy as their iPad software.
Perhaps in the future the state of mind of an EHR will be superior. As of now, as ZDoggMD points out, it is not.
Published in September 2017: The second edition of THE DOCTOR AND MR. DYLAN, Dr. Novak’s debut novel, a medical-legal mystery which blends the science and practice of anesthesiology with unforgettable characters, a page-turning plot, and the legacy of Nobel Prize winner Bob Dylan.
In this debut thriller, tragedies strike an anesthesiologist as he tries to start a new life with his son.
Dr. Nico Antone, an anesthesiologist at Stanford University, is married to Alexandra, a high-powered real estate agent obsessed with money. Their son, Johnny, an 11th-grader with immense potential, struggles to get the grades he’ll need to attend an Ivy League college. After a screaming match with Alexandra, Nico moves himself and Johnny from Palo Alto, California, to his frozen childhood home of Hibbing, Minnesota. The move should help Johnny improve his grades and thus seem more attractive to universities, but Nico loves the freedom from his wife, too. Hibbing also happens to be the hometown of music icon Bob Dylan. Joining the hospital staff, Nico runs afoul of a grouchy nurse anesthetist calling himself Bobby Dylan, who plays Dylan songs twice a week in a bar called Heaven’s Door. As Nico and Johnny settle in, their lives turn around; they even start dating the gorgeous mother/daughter pair of Lena and Echo Johnson. However, when Johnny accidentally impregnates Echo, the lives of the Hibbing transplants start to implode. In true page-turner fashion, first-time novelist Novak gets started by killing soulless Alexandra, which accelerates the downfall of his underdog protagonist now accused of murder. Dialogue is pitch-perfect, and the insults hurled between Nico and his wife are as hilarious as they are hurtful: “Are you my husband, Nico? Or my dependent?” The author’s medical expertise proves central to the plot, and there are a few grisly moments, as when “dark blood percolated” from a patient’s nostrils “like coffee grounds.” Bob Dylan details add quirkiness to what might otherwise be a chilly revenge tale; we’re told, for instance, that Dylan taught “every singer with a less-than-perfect voice…how to sneer and twist off syllables.” Courtroom scenes toward the end crackle with energy, though one scene involving a snowmobile ties up a certain plot thread too neatly. By the end, Nico has rolled with a great many punches.
Nuanced characterization and crafty details help this debut soar.
Click on the image below to reach the Amazon link to The Doctor and Mr. Dylan:
Learn more about Rick Novak’s fiction writing at ricknovak.com by clicking on the picture below: