The Epic Task Ahead for Clinicians

“But a bulldozer will do the same thing in a fraction of the time. IT was like this—speeding up dramatically work that can be done by hand.”

EPIC, the wonderful health informatics software that will revolutionalize health care, will be rolled-out in many of our Country’s top hospitals over the next few years. For those who don’t know, EPIC is an EMR database (electronic medical record) and pretty much EMRs generally, will be given a big task–to make our health system more efficient and bring it up-to-date with 21-century technology. Good luck with that!

In my experience so far, I haven’t seen the large rewards that it promises. I’ve found Epic to be another layer of paperwork. For most clinicians more paperwork is…well, it sure doesn’t make work any easier. New demands have a tendency to avert the practitioner’s focus away from the bedside.

It’s interesting to see how EPIC has affected clinical pharmacy at some hospitals. Clinical pharmacy micro-manages patient care mostly from a central or satellite pharmacy location. They review computerized physician orders. They verify medications on electronic data systems instituted by hospitals years ago, to do the same thing expected of EPIC–provide better, more efficient services.

I believe that new software should improve the manner in which a discipline practices, not change the method of practice altogether. What I mean is, it’s hard to fathom a clinical nurse being sedentary profession while the techs do all the running.

The day-to-day tasks of pharmacists seem to be following this trend. On any given day, clinical pharmacists are tasked with accesses patient information in a computer system, and then responding to gleaned data in an appropriate manor and entering their stamp of approval online. Repeat. Only when defects occur and clinically requires it (e.g., needed presence at a code) do they leave their post. Essentially, they inform most of their patient care decisions to a computer screen, not a patient, and then hope the software behind the computer screen does its job. This medium is sort of like a permeable barrier between the patient and practitioner, and is becoming ever-present on more clinical fronts.

How can we add new electronic systems without disrupting the essence of clinical practice methods? How can we maximize patient content when technology enables us to minimize it? What can we learn from pharmacy’s experience that we can use in nursing and medicine, or anywhere other field or practice for that matter? I strongly believe that professional methods of practice should not be affected. Patients need practitioners with them as much as possible for one reason: to get better. EPIC is a software, not a practice method, and the coders who created the software ultimately don’t know what is best for the patient.

Moral of the story: Keep the patient on the pedestal. Don’t replace her with something trendy. Work with the patient and find ways to use the tools to best fit her needs.

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