EPIC: learning another EMR system



Don’t keep this close to your vest,

It’s not something I’d utter in gest

I’ll reassure you

MedTech32

Certainly ranks as the best.

Synopsis:  I’m a family practitioner from Sioux City, Iowa.  In May 2010, I left my position of 23 years, and honoring my non-compete clause, traveled for a year doing locum tenens work.  In June of 2011 I joined up with the Community Health Center, which provides care for the underserved.  I’m now working part-time, which, for a doctor, means 54 hours a week.

One of our city’s two hospitals will soon adopt EPIC, a new electronic medical record (EMR) system.  In order to have privileges, all doctors must pass competency in its use by March 1.  The hospital pays for the training.  I spent 8 hours on Tuesday at the lectures, more training will follow.

I have trained into Allscripts, MedTech32, Centricity, and Cerner PowerChart.  MedTech32, the New Zealand national EMR, comes out the winner with no close second; easy to learn, easy to use, generating useful documents, and giving quick access to data.  All the others have steep learning curves, they all produce documents swollen to uselessness.  Allscripts brought slight workflow improvement after six months of getting used to the system.  Accessing data in Cerner and Centricity takes much longer than a paper chart.

The hospital in Barrow, Alaska gave me the option of learning a new EMR but I found using paper and pencil easier.  Given my short time there, I saw no advantage to spending 20 hours acquiring a skill set I would only use for 14 weeks.

At first impression, EPIC has attractive features.  With a consistent theme and layout, not exactly intuitive, but at least learning one section carries over to another section. 

I will reserve judgment till I’ve worked with it for six months. 

The class took place in a windowless basement room I had never visited despite working in that hospital for a quarter of a century.  I knew all 5 docs in the morning session and all 8 in the afternoon.

The lecturer and the book did a good job.  From time to time things the system did not respond as advertised.  I expressed dismay, the teacher reassured me that the learning environment has problems that the “real thing” doesn’t.

I voiced my skepticism.

Still, the EMR will not go away.  That the end-user doesn’t pay for the product constitutes the main problem; not nearly enough purchasing committees learned the moral of the story of The Emperor’s New Clothes.

 The daunting task of embracing new technology puts off many docs, especially ones that didn’t grow up with computers, and the record-keeping paradigm shift becomes the tipping point for a lot of physicians to leave medicine. 

The oft-cited complaint, “I went to med school to take care of patients, not to enter data,” carries a ring of truth.  I know I’d rather take care of patients, even smelly ones, than play with computers in a dark room for a couple of days.

At least one doctor announced he’ll retire the day before the system installs.

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