From the Headlines: Concerns about IT's Effect on Patient Care

At a recent meeting of the American Nurses Association, nurses stated that increased IT has added to their workload and cut down their time with patients. They expressed frustration over the fact that they often have to enter information into more than one system - for example, an electronic medical record and a prescription ordering system. While they feel a more integrated system might be better, one nurse still said, "Even with technology everywhere, patient care is still the main thing in nursing."

(To read the article in it's entirety, visit http://www.ihealthbeat.org/articles/2007/9/4/Nurses-Raise-Concerns-About-Health-ITs-Effect-on-Patient-Care.aspx)

While I recognize the need to streamline processes in an effort to lower costs, it has never made sense to me to require a nurse (or, heaven forbid, a physician!) to take on the additional responsibility of documenting the patient care encounter. These health professionals have been trained in patient care. This is their area of expertise. Accurate documentation requires a completely different set of skills.

Case in point: I recently visited my family practice doctor for my annual exam. The clinic I go to has installed docking stations in all of the exam rooms and the physicians and nurses now carry around laptop computers so that they can document their patients' encounters directly into their electronic medical record system using a series of drop down menus and text fields. When the nurse asked me to name my list of medications so she could type them into my record she stopped on "ranitidine, " asking me if I knew how to spell it. Of course I do! Not only am I an observant healthcare consumer, but I also happen to be trained in medical terminology and healthcare documentation (specifically, medical transcription). I carefully spelled it out for her, and under her breath she mumbled, "Hmm. I've never heard of that one." Perhaps if I had called it by it's brand name - Zantac - rather than the generic form, she would have recognized it.

The point is, this very capable healthcare professional went to school to learn nursing skills - how to take blood pressure and do wound care and assess patient needs. While the training of a medical transcriptionist may be similar in some respects to nursing (terminology, anatomy and physiology, study of disease processes, etc.), at one point the two professions branch off in entirely different directions. Just as you shouldn't expect a medical transcriptionist to accurately assess a patient's blood pressure, you should not expect a nurse to know the intricacies of accurate healthcare documentation.

I think the nurse quoted in the article above said it well - "...patient care is still the main thing in nursing." Though if the current trend continues, they can add documentation skills to their palette of skills.

If healthcare facilities really want to cut costs by adding extra responsibilities to already overworked staff, why not try having physicians clean the toilets and empty the trash cans at night? Surely they can save money by canceling their janitorial service. At least no one's life depends upon them doing a good job at that.