Clinicians and computers

Clinicians and computers

As I have blogged before, clinicians are ill-served by technology, EHRs in particular. EHRs' primary purposes are: Data gathering (legal and regulatory), and Billing ...not supporting clinicians. Here is my recent first-person essay on what this is like for this nurse.
Nurses and Computers

Nurses and Computers

Here I am, on a new clinical rotation during my last semester of nursing school, having taken my patient’s vitals, assessed her skin (she is elderly, bed-bound, and at risk for bedsores), tracked her Is and Os, straightened up her bed, and it is time to do the charting before moving on to my next patient. Some earlier clinicals had been in pre-EHR (electronic health record) hospitals and I had appreciated the fine-tuned process in which, with a few check-marks („charting by exception“) and notating the changes (fortunately, my patient’s health was improving) I would have been done with this task in a couple of minutes.
What SNFs must do

What SNFs must do

In an excellent article, Asymptomatic Transmission, the Achilles' Heel of Current Strategies to Control Covid-19, the venerable New England Journal of Medicine (NEJM) offers a strategy for SNFs to combat the…
It’s the Workflow, Stupid

It’s the Workflow, Stupid

When nurses complain that the technology-based tools (especially EHRs) that they are tasked to use slow them down, usually what they mean is that these tools don’t model their workflow. We talk about workflow a lot! But what is it? Why is it so important? And why is it so hard to model with computerized/electronic/mobile tools?
Laguna Honda Hospital and Rehabilitation Center — San Francisco

A garden to tend

I recently read Dr. Victoria Sweet's 2012 recounting of her twenty years at San Francisco's venerable Laguna Honda rehabilitation center, recently transformed from almshouse (the last one in America) to hospital. Her…