Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

Everyone hates the electronic medical record

logicmag.io

Post reply on HN
Print view View original

101–110 of 343 posts

Re: Everyone hates the electronic medical record

#101

Post by ClikeX »

hiAndrewQuinn wrote: post #90

My first job out of college was working at Epic Systems as a mostly Windows sysadmin. It was a fascinating (and great!) experience. I've never seen such an advanced Windows sysadmin setup before. I only briefly touched upon EMRs and the MUMPS/Cache stuff they did there. However, I also learned PowerShell to a much deeper level than probably 99% of Linux folks ever do. We did TDD, code review, CI/CD pipelines for fuck…

The reason why we use Bash on Linux is because it’s ubiquitous. Even though my terminal is ZSH, all my scripts will be Bash because I can trust it to run on any system.

Same goes for Windows, I want to make sure those scripts can be run without having to install anything. Powershell is there, and it’s powerful.

I’ve got a job to do, and a problem to solve.

Re: Everyone hates the electronic medical record

#102

Post by autarch »

boxed wrote: post #75
ianso wrote: post #29

Popping up here to mention OpenMRS, a healthy open-source EMR used by hundreds if not thousands of facilities across the world, mostly in Africa and Asia. An old version is packaged/integrated with some other apps into Bahmni, which is a full-blown hospital management system. Honestly, people complain about software all the time and all software sucks to some extent, some more than others of course. Complaining about…

I believe this article is only about this specific system. The problem is that the name of the system is "Electronic Medical Record", which makes the article sound like all such systems are hated.

I don't think that's the case. AFAIK there's no such system. The article specifically reference Epic, which is one of the biggest (_the_ biggest?) EHR software company in the US. My wife used it as a nurse and I've watched my own providers struggle with it. It sucks.

Re: Everyone hates the electronic medical record

#103

Post by lostlogin »

oldgradstudent wrote: post #44

When my Israeli health care provider switched to electronic records in the mid-late 1990s, a typical medical appointment had two parts, roughly similar in length. During the first part, the doctor would complain about how the system crashes, how hard is it to type with two fingers, and how computers are pointless. In the second part, I’d complain about my flu/cold symptoms.

It could be worse. You could both be complaining about viruses.

Re: Everyone hates the electronic medical record

#104

Post by foofie »

hiAndrewQuinn wrote: post #98
foofie wrote: post #97

Earlier quoted context omitted.

> PowerShell actually rules for readability and maintainability when you have people who know what they're doing. Isn't that true for all programming languages ever devised by mankind? > HNers by and large don't understand the economics of PowerShell. There is a very low supply of competent PoSh devs on the market, and even fewer interested in credibly signaling their proficiency, but a very high demand for them, bec…

One would hope, but alas! Perl was notorious for being write-only back in the day. PoSh is closer to read-only for most devs. If someone makes sure to write things out the long way (or uses a linter to do this) it's very easy to grok. Actually learning to write it is the tricky bit.

> One would hope, but alas! Perl was notorious for being write-only back in the day.

I don't agree that's a valid rebuttal, as the operative word is the weasel copout "know what they are doing".

> PoSh is closer to read-only for most devs.

A read-only language is a language with a serious expressiveness problem. In contrast with, say, Python, which you need to go way out of your way to write code that's hard to understand.

Re: Everyone hates the electronic medical record

#105

Post by hiAndrewQuinn »

foofie wrote: post #97
hiAndrewQuinn wrote: post #90

My first job out of college was working at Epic Systems as a mostly Windows sysadmin. It was a fascinating (and great!) experience. I've never seen such an advanced Windows sysadmin setup before. I only briefly touched upon EMRs and the MUMPS/Cache stuff they did there. However, I also learned PowerShell to a much deeper level than probably 99% of Linux folks ever do. We did TDD, code review, CI/CD pipelines for fuck…

> PowerShell actually rules for readability and maintainability when you have people who know what they're doing. Isn't that true for all programming languages ever devised by mankind? > HNers by and large don't understand the economics of PowerShell. There is a very low supply of competent PoSh devs on the market, and even fewer interested in credibly signaling their proficiency, but a very high demand for them, bec…

Re/ the economics: It's okay, many people don't get a formal course in this stuff. First look at the graph with two lines on https://en.wikipedia.org/wiki/Supply_and_demand. Notice that the y-axis is P for Price.

Now imagine first off what happens to Price when you shift the downward sloping curve forward. That is what economists call the demand curve. Does Price go up or down?

Finally, imagine what happens to Price when you shift the upward sloping curve backward. That is what economists call the supply curve. Does Price go up or down?

Re: Everyone hates the electronic medical record

#106

Post by lostlogin »

consp wrote: post #41
perilunar wrote: post #23

I spent two hours this morning helping my elderly mother fill in a hospital admission form online. The session timed out just before submission, but we logged in again and everything was saved. I'm grateful that it was online, so I could help her remotely via screen sharing and not have to travel to fill in forms (I'll visit when she goes in, just don't want to have to travel repeatedly for paperwork.) Entering medic…

> Entering medical history and current medications was a pain in the arse though, and is something we have done many, many times over the last few years. Isn't this something what electronic records should have solved? I know doctors always ask the patient but they all have access to that data here (not us). Especially the pharmacy looks at it to check for cross interactions (or a note waiving them).

The idea that patients take the prescribed medications is one that many people believe. Another problem is that people believe the patient’s reply when they are asked what medication they take.

Re: Everyone hates the electronic medical record

#107

Post by lostlogin »

sullivantrevor wrote: post #57

i design an EMR for a veterinary company based in LA. can confirm our care team gets quite upset with the software at times. it is incredibly difficult to build a great user experience for all the different positions and use cases that occur throughout the day. with that said, it has been a fun and rewarding experience over the last 4 years. we are hard at work bringing AI into the EMR right now.

> we are hard at work bringing AI into the EMR right now

I’m sure there are benefits so be had from AI in an EMR at some point, but many would see it as a vast upgrade just to have a system that responds to clicks, doesn’t lag and kind of does what it says it will.

Re: Everyone hates the electronic medical record

#108

Post by lostlogin »

balderdash wrote: post #87
hashishen wrote: post #76

Earlier quoted context omitted.

the issue arises when you are unconcious and there are certain risks to treating you the staff needs to know about. Maybe your throat closes for benedryl but you're showing obvious signs of an allergy? Maybe you have a pre-existing condition which gives you symptoms that signal a stroke? the risk is always going to be there

Isn’t this the case with most emergency situations? My guess is that if that I end up in the ER unconscious they’ll have no records on me…

What if we all get microchipped? Maybe have duplicates so that the time you cut your arm off doesn’t mean your record gets left behind.

Re: Everyone hates the electronic medical record

#109

Post by jackvalentine »

wharvle wrote: post #9
jackvalentine wrote: post #3

Disclaimer - I work for a health service that isn't in the USA and has a very extensive EMR. I don't disagree. I started my career dealing with paper folders of records that were fastidiously organised by a team that made sense of them. Now everything is electronic and fucking _everywhere_. The work didn't go away - but giving everyone a computer made it everyone's problem and nobody's job. A really good EMR (or othe…

This is everywhere. We made everyone their own secretary but gave them crappy tools and no training. Also they’re never gonna be doing it more than very part-time, so will always tend to be bad at it and find it a distraction from the work they’re actually good at. I’m skeptical computerization has even been a net benefit for productivity for most jobs , for that and other reasons. I think it’s been such a huge boost…

> We made everyone their own secretary but gave them crappy tools and no training. Also they’re never gonna be doing it more than very part-time, so will always tend to be bad at it and find it a distraction from the work they’re actually good at.

This is, 100% exactly it. Then we have to design systems for the absolute lowest common denominator to get any semblance of sense from it and anyone with the slightest bit of clever just has to deal with it.

Re: Everyone hates the electronic medical record

#110

Post by lostlogin »

jrockway wrote: post #40
kQq9oHeAz6wLLS wrote: post #38

Earlier quoted context omitted.

In the US, that's a HIPAA violation, which opens the provider up to massive fines.

It's definitely not. As a patient, I can do whatever I want with my medical records. I can copy them right out of MyChart and put it on my blog if I want to. I feel like I should have the right to sign a form saying they can email me.

This agrees with you:

https://www.hhs.gov/hipaa/for-professionals/faq/570/does-hip...

Post reply on HN