We ran out of blank physician charts in the ED today, so we photocopied one and used those copies until the new order came in. As I used the photocopied “chart” today over and over again for each patient I repeatedly noticed the crooked angle of the lines and boxes that occured as a result of manually copying the chart. The wrinkles embedded in the ‘original’ we used to make photocopies had probably occurred as this single sheet of paper remained hidden behind a file cabinet where it had fallen God only knows when. The only reason we even had a blank sheet to photocopy is because it had fallen behind the cabinet hidden from us until we discovered we had completely run out of blanks. We only discovered it as the clerk desperately searched for a blank record to use. We all worked on our patients and Emergency Department tasks oblivious to the fact that we had run so low on this particular form, so dark lines and blots were all over every official chart I used today.
The charts looked so unprofessional it was an embarrassment, even though few people would ever set their eyes on them. My work is permanently recorded on these blemished forms, and it just does not look right. My handwriting always adds an element of disorder to the charts as well (I can either spend my time trying to write pretty or seeing patients). It is while working in this backdrop that I repeatedly hear about the plans to digitize electronic medical records as I read the paper or listen to the nightly news. This seems like an excellent plan, at first. Then it hits home that many hospitals are simply scanning the hand written charts into their computer archives to satisfy compliance with digitized medical records, blotches, crooked lines and all. In other cases patient visits are computerized from beginning to end, but often using awkward and user unfriendly systems. I still love what I do, but I imagine the affection I will have for my field if I had the tools to do it better and easier.
Medicine is easily 10 to 20 years behind almost every other industry in terms of technology. There are the usually excuses of not enough funding, and the need for patient privacy, but if credit card companies can maintain internet security and create user friendly interfaces in industries where hackers have infinitely more motivation to breech security systems then why can’t we?