411–420 of 751 posts
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I just don’t get why you wouldn’t choose someone a little… brighter to represent you.
I did not take a position on unions one way or the other on my post there. As i said, i just found it shocking that "join a union" was their only response. Labour laws impact everyone, union contracts don't.
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> Another study found US clinicians write 4x longer notes I wasn't aware of this, but as the spouse of a medical provider I know that most US providers are burdened with an ever-present worry about malpractice.
This. So much this. In residency we are taught “document, document, document” and “this is a medical legal document” which leads to defensive medicine. Another point of why we spend more time documenting is billing. Coders/billers continue to come back and asking us to add more details about a diagnosis. More details = more charges to bill or up level. So the next progress note or office visit, I go back to add more.…
How does this reduce/eliminate the “better document this thoroughly in case I get sued” work?
Or are the legal worries overblown/over-relied upon for over-documentation?
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Nobody wants to pay for better GUIs in enterprise software, so no vendor puts any attention into them. An Enterprise Architect explicitly explained to me (when I was raising a point of choosing a software package that had much better UI) that good UX is a small factor and company (a bank in that case) would rather buy cheaper software and just have its workers suffer more, because it's deemed more cost-effective.
The definition of enterprise software is “the customer is not the user”. You don’t have to make the user happy, just the CxO.
We live in a society where every single thing is a rent seeking and nobody believes in anything besides winning because everything of substance has been hollowed out.
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I mean it's such a small percent do you really think it would show up in national data?
What is such a small percent and where are you getting your data?
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But the doctors almost always were taking notes anyway. My step father (A doctor) fought a losing battle against electronic records because he had _decades_ of paper records stored in the "records" room of his office. That was largely the responsibility of the front desk to pull the patients records and have them ready for him to read/check before seeing the patient. Then clean them up and refile them. Long term pati…
Sounds about right For those that seemed to transfer successfully, I noted that at Mayo Clinic, the doctors use live dictation software and dictate at least some of their notes into the system while the patient is present near the end. This immediate review sometimes brings up a few new questions (from either Dr or patient), and a bit more notetaking. So, it looks like a very efficient system. They also have no appar…
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> I've read that doctors now spend as much as 50% of their time documenting their work. Companies such as Epic, which provide the software that hospitals use to build databases of patient data, have been big winners in the new world of hospitals-depending-on-software. But did the doctors become more productive? By almost any measure, they became less productive. I don't think "by almost any measure" is right. I think…
Medical decisions are based primarily on financial profit, and patient outcome data is not required to determine which medicines are most profitable. The point of extensive documentation is shielding from the worst of malpractice lawsuits. The legal system is still of the legacy opinion that doctors have a responsibility to their patients as opposed to the more modern understanding of responsibility toward pharma com…
This is blatantly false. Pharma spends tons of money to buy this data for their armies of researchers in order to determine outcomes. There's an entire very lucrative industry (that I work in) which exists to source this data from hospitals and refine it for researchers.
If the point of documentation was CYA, then you wouldn't need complicated systems like Epic to standardize the documentation and make it available for electronic processing (you would just have some paralegal pour over the records of the individual patient).
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I don’t think productivity was ever the goal of this software. It was to have a record that is standard, digital, transferable, etc. Doctors fought it as long as they could because they knew what it meant for them. I remember pretty early demos in early/mid 2000s when I was doing some clinical grunt work in college. I had written some software to make my department’s life easier so I was offered up as the hospital’s…
I used to work in Healthcare software (Not Epic). Productivity is indeed a selling point. I will also tell you that EHR software is universally hated by doctors. Does not matter who makes it. The company that cracks that will make billions. One interesting idea was a voice assistant wired up to take inputs as doctors did their work. I don't think it went anywhere (yet).
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> notably healthcare researchers use this data to improve patient care, develop new medicines, and to precisely identify which medicines are likely to help on a particular patient (and which medicines may even harm them!) The majority of the notes being written by doctors now is boilerplate. A lot of it is copy-pasted. It's written because of insurance companies (which have incentive to deny claims), because of liabi…
> But you could probably reduce the paperwork that doctors do these days by a factor of 4 and not loose anything of value. Maybe, but this sounds like some vague hunch based on ???. I very highly doubt the healthcare industry would tolerate doctors wasting ~37.5% of their time (75% of paperwork time is wasteful * 50% of doctors' time spent on paperwork = minimum 37.5% of doctors time wasted). Doctors are expensive ,…
Doctors are expensive, but malpractice lawsuits are more expensive. Documentation is extremely important for lawsuits. If you get sued because a patient you saw last year later died and they're alleging improper health care(just to use a random example), it's highly dependent on having meticulously documented notes that document every single examination finding and treatment administered. Your memory isn't going to be accurate, and the prosecutor is going to be looking for any errors in documentation they can use.