Eliminate Print Servers: go LANless?

Jason

You'd like to think that, the info is in another system. Bit that requires digging around in that system to find it... So they pay the staff to spend mins digging instead of themselves. Then once they find it... There is no way to keep it front and center while moving onto those next task without printing or something similar.

So you have an issue with data presentation and organization not printing. The data is already there they just need an app to display it properly.

Dashrender

@scottalanmiller said:

@Dashrender said:

@Jason said:

@Dashrender said:

Our nursing staff is constantly asked to get records from another system for our doc to look at for 20 second before being tossed right into the shred bin.

This would eliminate that waste. And actually possibly allow a safer situation for the information, you're done with it.. Delete it. Could be setup for auto delete after x days, less risk of paper going missing and not being shred.

Seems like thinking about it the wrong way. If the records are already in digital form why is printing needed just because they do it now. a better solution would be a mobile app for the patient record system.

You'd like to think that, the info is in another system. Bit that requires digging around in that system to find it... So they pay the staff to spend mins digging instead of themselves. Then once they find it... There is no way to keep it front and center while moving onto those next task without printing or something similar.

If you have an outside the box idea for that I'm all ears.

What I don't really get is how does physical paper do this when digital paper does not? It is that they can't resist playing Flappy Birds between office visits? If the staff get a PDF or other information up on the screen and hands it to the doctor, how is that more confusing than paper?

Creating a PDF steps.
Click print
Choose PDF printer
Give name for file - assume location on network to be saved is automatic
Grab iPad
Find file open file
Hand to doc

Printing or app idea.
Click print
Choose ap or printer
Grab ipad/paper
If pad launch app otherwise skip
Hand paper or pad to doc

At minimum it saves the step of the employee naming the PDF.

Next you'll say well just accept the default. That still means the staff have to remember that file name to find on the pad.

scottalanmiller

@Dashrender said:

@scottalanmiller said:

@Dashrender said:

@Jason said:

@Dashrender said:

Our nursing staff is constantly asked to get records from another system for our doc to look at for 20 second before being tossed right into the shred bin.

This would eliminate that waste. And actually possibly allow a safer situation for the information, you're done with it.. Delete it. Could be setup for auto delete after x days, less risk of paper going missing and not being shred.

Seems like thinking about it the wrong way. If the records are already in digital form why is printing needed just because they do it now. a better solution would be a mobile app for the patient record system.

You'd like to think that, the info is in another system. Bit that requires digging around in that system to find it... So they pay the staff to spend mins digging instead of themselves. Then once they find it... There is no way to keep it front and center while moving onto those next task without printing or something similar.

If you have an outside the box idea for that I'm all ears.

What I don't really get is how does physical paper do this when digital paper does not? It is that they can't resist playing Flappy Birds between office visits? If the staff get a PDF or other information up on the screen and hands it to the doctor, how is that more confusing than paper?

Creating a PDF steps.
Click print
Choose PDF printer
Give name for file - assume location on network to be saved is automatic
Grab iPad
Find file open file
Hand to doc

Printing or app idea.
Click print
Choose ap or printer
Grab ipad/paper
If pad launch app otherwise skip
Hand paper or pad to doc

At minimum it saves the step of the employee naming the PDF.

Next you'll say well just accept the default. That still means the staff have to remember that file name to find on the pad.

You missed steps like having to wait for the printer, having to secure the printer, making sure that you have your paper and not someone else's and having to track the paper and shred it afterwards.

scottalanmiller

@scottalanmiller said:

Creating a PDF steps.
Click print
Choose PDF printer
Give name for file - assume location on network to be saved is automatic
Grab iPad
Find file open file
Hand to doc

The obvious answer is... this is all dumb and you should have an application that does this, not people. And no printing, PDFs or similar should be involved. That's just weird.

But even given that process.... it seems like this could pretty easily be changed to:

Click Print
Hand iPad to Doc

If the printer device makes a PDF automatically on the iPad and opens the PDF, all other steps are eliminated. You just have to choose the right printer to have as a default.

Dashrender

@Jason

So you have an issue with data presentation and organization not printing. The data is already there they just need an app to display it properly.

Not sure what you mean by properly- easily is a better way to think of it.

The docs claim, and perception is king, that it takes longer to find stuff in a EHR than a paper chart. I will give them that it takes longer to enter data... On paper you just write what med you want. In EHR you find it in a huge list, requiring scrolling... Etc.
Same goes for orders etc.
It's no longer write what you want. It's find what you want from a long list.
Is it better for patient care? Hell yes, does it take longer? Oh hell yeah.

Dashrender

Click print
Hand to doc is what I want

Do you have a solution that will do that?

scottalanmiller

@Dashrender said:

@Jason

So you have an issue with data presentation and organization not printing. The data is already there they just need an app to display it properly.

Not sure what you mean by properly- easily is a better way to think of it.

The docs claim, and perception is king, that it takes longer to find stuff in a EHR than a paper chart. I will give them that it takes longer to enter data... On paper you just write what med you want. In EHR you find it in a huge list, requiring scrolling... Etc.
Same goes for orders etc.
It's no longer write what you want. It's find what you want from a long list.
Is it better for patient care? Hell yes, does it take longer? Oh hell yeah.

Or is it because it is slower, more costly, more risky and makes them more billable hours?

scottalanmiller

I believe hand writing should be illegal for doctors to do. It's careless and reckless in this day and age. Sure if there is an emergency and a power outage or something, but for intentional care? I'd fire any doctor so incompetent and clueless. If they need to handwrite, how can they be capable of valid patient care? This is a serious question. Many of my family members are pharmacists and they talk constantly about the lives that they save from uncaring, incompetent doctors willing to kill their patients rather than have legible medical information.

scottalanmiller

They handwrite here in Greece, but they also don't HAVE computers. There isn't any money for them. And the handwriting is nothing like what you see in the US.

scottalanmiller

I wonder what percentage of malpractice insurance exists only to cover the risks caused by handwriting instead of using digital records?

Dashrender

@scottalanmiller said:.

Or is it because it is slower, more costly, more risky and makes them more billable hours?

I know you think all US health care is out to screw you, but we get paid in my office by the visit, not amount of time spent with the patient.

Being more efficient might allow us to see more patients and make more money... But not spending money on paper definitely would save is money as long as the solution doesn't cost more than the paper savings.

As for securing the printer... I laugh in your general direction.

scottalanmiller

@Dashrender said:

I know you think all US health care is out to screw you, but we get paid in my office by the visit, not amount of time spent with the patient.

You can convince me that they care when they do things like take the "time" to keep patient data safe and don't handwrite. You cant defend their intents after describing their processes and what they prioritize.

stacksofplates

@Dashrender said:

You'd like to think that, the info is in another system. Bit that requires digging around in that system to find it... So they pay the staff to spend mins digging instead of themselves. Then once they find it... There is no way to keep it front and center while moving onto those next task without printing or something similar.

I'm confused why this can't be done with a query to the other system? Why do they have to dig around?

In the simplest for I could think of (which would be terrible for a non power user) would be to

find the file
put in folder assigned for specific doctor that's running Python's SimpleHTTPServer
doc refreshes page
clicks new document

Obviously a terrible work around, but that would take seconds. This could be done with Drupal in about a day. If you're using Oracle, it could be done with APEX in about the same time.

scottalanmiller

@johnhooks said:

@Dashrender said:

You'd like to think that, the info is in another system. Bit that requires digging around in that system to find it... So they pay the staff to spend mins digging instead of themselves. Then once they find it... There is no way to keep it front and center while moving onto those next task without printing or something similar.

I'm confused why this can't be done with a query to the other system? Why do they have to dig around?

And how they get distracted by the digital form of the data.

Dashrender

@scottalanmiller said:

@Dashrender said:

I know you think all US health care is out to screw you, but we get paid in my office by the visit, not amount of time spent with the patient.

You can convince me that they care when they do things like take the "time" to keep patient data safe and don't handwrite. You cant defend their intents after describing their processes and what they prioritize.

They only hand write narcotics today... Everything else is digital.

scottalanmiller

@Dashrender said:

I know you think all US health care is out to screw you,

Your descriptions of your office processes in patient care, security, common sense, etc. don't do anything to discourage my impressions of the health care. Yes, I firmly question the motives of many in the health care system... but I don't react to that when you describe what is happening in the health care practice that you describe. The concerns are based off of what they are actually doing there.

scottalanmiller

@Dashrender said:

@scottalanmiller said:

@Dashrender said:

I know you think all US health care is out to screw you, but we get paid in my office by the visit, not amount of time spent with the patient.

You can convince me that they care when they do things like take the "time" to keep patient data safe and don't handwrite. You cant defend their intents after describing their processes and what they prioritize.

They only hand write narcotics today... Everything else is digital.

@Dashrender said:

@scottalanmiller said:

@Dashrender said:

I know you think all US health care is out to screw you, but we get paid in my office by the visit, not amount of time spent with the patient.

You can convince me that they care when they do things like take the "time" to keep patient data safe and don't handwrite. You cant defend their intents after describing their processes and what they prioritize.

They only hand write narcotics today... Everything else is digital.

That's good. Why is the one special? Does it have a problem that they need to bypass the normal security measures?

Dashrender

@scottalanmiller said:

@johnhooks said:

@Dashrender said:

You'd like to think that, the info is in another system. Bit that requires digging around in that system to find it... So they pay the staff to spend mins digging instead of themselves. Then once they find it... There is no way to keep it front and center while moving onto those next task without printing or something similar.

I'm confused why this can't be done with a query to the other system? Why do they have to dig around?

And how they get distracted by the digital form of the data.

I don't think ita about distraction. It about just finding things.

Most charting systems show just a list of office visits, if you are looking for something done at some previous visit, you have to open each one until you find what you want. Hell you might not even know what you want, you just want to skim than all. That is a pain... Is it in reality more of a pain in EHR than old paper chart, probably not... Bit its definitely not easier.

I'm not making excuses for them.
I'm trying to make things better within the realm that I can. I can't put a gun to their head and demand they atop being lazy and find their own shit. They choose to spend their money on having staff look it up for them so they can go directly to the data they was as is possible.

Dashrender

@scottalanmiller said:

@Dashrender said:

@scottalanmiller said:

@Dashrender said:

I know you think all US health care is out to screw you, but we get paid in my office by the visit, not amount of time spent with the patient.

You can convince me that they care when they do things like take the "time" to keep patient data safe and don't handwrite. You cant defend their intents after describing their processes and what they prioritize.

They only hand write narcotics today... Everything else is digital.

@Dashrender said:

@scottalanmiller said:

@Dashrender said:

I know you think all US health care is out to screw you, but we get paid in my office by the visit, not amount of time spent with the patient.

You can convince me that they care when they do things like take the "time" to keep patient data safe and don't handwrite. You cant defend their intents after describing their processes and what they prioritize.

They only hand write narcotics today... Everything else is digital.

That's good. Why is the one special? Does it have a problem that they need to bypass the normal security measures?

Ask uncle Sam... It's current a federal requirement

Though the fed is working to solve it, so they say.

Dashrender

@Dashrender said:

@scottalanmiller said:

@Dashrender said:

@scottalanmiller said:

@Dashrender said:

I know you think all US health care is out to screw you, but we get paid in my office by the visit, not amount of time spent with the patient.

You can convince me that they care when they do things like take the "time" to keep patient data safe and don't handwrite. You cant defend their intents after describing their processes and what they prioritize.

They only hand write narcotics today... Everything else is digital.

@Dashrender said:

@scottalanmiller said:

@Dashrender said:

I know you think all US health care is out to screw you, but we get paid in my office by the visit, not amount of time spent with the patient.

You can convince me that they care when they do things like take the "time" to keep patient data safe and don't handwrite. You cant defend their intents after describing their processes and what they prioritize.

They only hand write narcotics today... Everything else is digital.

That's good. Why is the one special? Does it have a problem that they need to bypass the normal security measures?

Ask uncle Sam... It's current a federal requirement

Though the fed is working to solve it, so they say.

I do agree, I don't understand why the current electronic med system wasn't considered secure enough for narcotics... I'm guessing it was just political.