Finals and EPIC

So, first of all, the Master's Program: I got a really kickass group from this class to do a group project with, really motivated people who cared about what they were doing. We did a proposal on using thumb drives to create a little update file for replacing all the medical forms you fill out with each doctor's visit: insurance changes, address changes, new doc gets the whole medical history thing that you fill out every time.

We presented last night, and I feel very good about it. My kudos to the team.

The final is non-cumulative and open note. They are supposed to email it to me ahead of time. I hope I will complete it before I have to show up in person (a requirement of the university), and then just upload it and run.

So the second thing, while we were wrapping up the last week of school, I started the first session of the "Phase IIA" replacement by EPIC of Carevue at our hospital. Currently we use a program by Phillips called Carevue to do our charting. It doesn't interface with too much, although lab and the vitals monitors receive information. My really big complaint about Carevue is that it doesn't let me use any keyboard shortcuts, so if I go to a station where the trackball is missing or the mouse is crap, I'm screwed.

However, since we have switched to EPIC already for charges and medication administration, the hospital is going to convert, eventually, everything to EPIC. So I got in on this second phase of implementation.

Very interesting. I'm learning that the basic atmosphere, not just at our hospital, is the clinicians feel passionately that this interface should look and perform a certain way, and the IT people are faced with the limitations of the current IT soup at their hospital, the need to upgrade infrastructure, and the fact that these changes very quickly spiral out of control for the number of hours it takes to develop things, the amount of upgrades that need to be done on the network, etc.

So the clinical people, in this phase mostly nurses, don't understand what's going on at the IT end of things, and they are rather unforgiving of the system not being an exact replica of their current paper charting. And the IT people, unable to get away from other work--they sit there in the session working on their laptops--are a little defensive, and somewhat hard to talk to.

Like I said, I think this is par for the course as to how Health IT and clinicians are currently interacting with each other. So I hope to use my "middle ground" of experience to make things more harmonious on both sides.

The other thing is, for as long as I am at this hospital, I'm going to look at our processes in respiratory and see the opportunity to improve processes. For us, that means especially discharges.