Back in Pennsylvania, Urgent Care and a Transformed EMR


It’s an updated, revised, EMR

In the last five years it’s come far

But down the wrong road

It’s as slow as a toad,

It can push a doc towards the bar.

Synopsis: I’m a Family Practitioner from Sioux City, Iowa. In 2010 I danced back from the brink of burnout, and honoring a 1 year non-compete clause, travelled and worked in out-of-the-way places in Alaska, Nebraska, Iowa, and New Zealand. After three years working with a Community Health Center, I am back having adventures in temporary positions until they have an Electronic Medical Record (EMR) system I can get along with. I spent the winter in Nome, Alaska, followed by assignments in rural Iowa. This summer included a funeral, a bicycle tour in Michigan, cherry picking in Iowa, a medical conference in Denver, and two weeks a month working Urgent Care in suburban Pennsylvania. Any patient information has been included with permission.

I drove the large rental car away from the airport into the Pennsylvania countryside. A simple transposition of two numbers for my phone contact with the hospital led to confusion and tension.
I stopped into a UPS store. As I walked in, the clerk looked up and said, “Here for fingerprints?”
“How could you tell?” I asked.
“The piece of paper you’re carrying,” he answered.
The new inkless technology contrasted to my last fingerprinting 5 years ago in Barrow, Alaska; everything about the northernmost point in the US qualifies as a unique experience.
Finished with fingerprinting, I figured out the phone number, got ahold of my contact, and entered the right address into my GPS unit.
Fall colors dominated the forests, and cute furry animals like deer, possum, and raccoon littered the country roads with their lifeless bodies. A few cornfields retained a trace of green, but most stood dry and ready for the harvest. Huge round bales of hay lay scattered over alfalfa fields. It felt a lot like home in Iowa, but agriculture here has to deal with a more and steeper hills.
The GPS took me to an address having nothing but buccolic pastures. I followed the properly named road another mile and came to a new-loooking medical building.
The Urgent Care clinic has its own CT scanner and MRI machine, but rarely used for same day studies from Urgent Care. I had a good conversation with the doc there. He showed me around, praised the nursing staff I’d have the next day, and walked me through an electronic medical record system I’d worked with while in private practice.
But this version suffered from updates and looked nothing like what I remembered. It boasted spiffy colored graphics but shuffled and gimped like a zombie. I took notes, and, at the end, I drove back to a Chinese buffet, ate large, came back to the hotel, and slept hard.
The next day started off busy, and the EMR became even more truculent than I could have imagined. It suffers from a counter intuitive, chaotic layout. It runs slowly, with plenty of 15 second click-and-wait features.
With incomplete documents piled well into the double digits, I got a call from an ER doc who talked me through the trouble spots, and as the patient flow lightened, the annoying data entry sped up.
I finished my charting on time, leaving at 9:00PM sharp.
The stress of learning a new EMR system took a toll. I remembered back to the time when the Practice Formerly Known As MIne made the conversion from paper. The steep, six-month learning curve took me well outside my zone of comfort. Halfway through the process, I had a second glass of wine on Friday night while at supper with friends, and not before nor since has my wife has seen me consume alcohol under stress. She doesn’t remember it. I do. But I didn’t have a drink when I got back to the hotel. It would have ruined my sleep.

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