Instead, he and others urge third-party vendors be allowed to design programs and software that can help. He likens it to independent application developers building programs for iPhones and Androids, as opposed to firms like Apple saying that only their internally developed applications would be used.
“Apple would be nowhere right now” had they done that, Dr. Rogers says. “What made them successful was creating a marketplace that all of these individuals out there—thousands of people—could start designing innovations and applications that would fit what that population needed, no matter how small that population was.”
He says a single system, applicable across all healthcare settings, would make an “even playing field for third-party vendors.”
“I think we could get there much faster,” he says. “Within a five-year period of time, I think we could solve a lot of these issues that we’re having right now.” TH
Richard Quinn is a freelance writer in New Jersey.
CTRL-C + CTRL-V = DANGER
Cut-and-paste is as basic a technique as there is in word processing. But with electronic health records (EHRs), that simple maneuver is becoming a danger as repetitive orders, outdated diagnoses, and other inaccurate information is just moved forward unwittingly.
“It’s almost ubiquitous in many cases,” says Kendall Rogers, MD, CPE, SFHM, chief of the division of hospital medicine at the University of New Mexico Health Sciences Center in Albuquerque and chair of SHM’s Information Technology Committee. “Certainly, almost every note that I see in our EHR has some portion of cut-and-paste in it.”
The phenomenon is one borne of a simple workaround. Much of the daily note input on an admitted patient’s screen is repetitive and time-consuming, says hospitalist Cheng-Kai Kao, MD, medical director of informatics at the University of Chicago Medicine. So it might seem to make sense to reuse yesterday’s note today.
But if the note called for a test or a treatment, mistakes can happen.
Dr. Kao
“We are trying to create new note templates that allow extracting discrete data for billing and research purposes,” Dr. Kao says. “We don’t allow [users] to copy easily, but we do try to make it much easier for them to write a note. So they wouldn’t be copying exactly the same notes from yesterday, but in the meantime, they are able to put in some meaningful information each day.”
Put more simply: “When the right things are made easier to do, people tend to do the right thing. And that is our goal.”
Dr. Rogers suggests keeping the dangers of cut-and-paste errors front of mind and, similar to other EHR documentation issues, lobbying for improvements to the system itself.
“Copy-and-paste is our workaround for poorly designed documentation systems,” he adds. “That does not make it right to use it, but the way to eradicate it is to build better systems that allow documentation to become a part of providing care.”
—Richard Quinn