Are the health IT hyper-enthusiasts inept, or merely insane?

By Unknown at 4:32 PM

From a psychiatrist, partially in response to the article about me in Kaiser Health News, on the travails of health IT.

They write:

... In psychiatry we screen for certain medication side effects using a tool called "DISCUS."  [Dyskinesia Identification System Condensed User Scale - ed.] In a paper and pen world, we (1) reviewed a single page; (2) circled a score; (3) signed and (4) dated.

In [redacted] EHR, we need to do the following to complete one DISCUS…
    
DISCUS Completion in [redacted] EHR:

• 1.  Log in;
• 2.  Acknowledge to do items by choosing “ok”;
• 3.  Go to “my to do list.”

Then:

• 4.  Double click specific date of to do items to complete (this reveals the specific to do items)
• 5.  Right click specific patient’s name
• 6.  Choose “enter option”
• 7.  Review all 3 pages under “assessment” tab (click through each page)
• 8.  Then choose “evaluation” tab
• 9.  Review “evaluation” (keeping in mind the total score from last page of “assessment”)
• 10.  Choose your “conclusion” in item 5
• 11.  Add “comments” as indicated (item 6)
• 12.  Under “name/ID number” type in the first characters of your last name (or your ID number)
• 13.  Select your name
• 14.  Go to the bottom under “select physician to notify” and UNcheck your name
• 15.  Click “yes” under “is evaluation section complete and ready to be locked?”
• 16.  Confirm above choice by choosing “ok”
• 17.  Press “submit” button across the top
• 18.  Now go back to “my to do list” and you’ll see that the item you just processed above is still there -- double click the same to do item that you just finalized (and processed in item 5 above)
• 19.  Then check “reviewed”
• 20.  Then press “submit”
• 21.  Then press “refresh” and the item will be completed (refresh does not need to be done after each DISCUS)

Finally:

• 22.  For processing of additional DISCUS for a given “sign on," go back to step 3, 4 or 5 (as needed), and repeat.

And this is just the easy stuff.

I'm not a psychiatrist, but I can opine with confidence that anyone who expects human-computer interaction such as this to "revolutionize medicine" is insane.

Perhaps this helps explain city-wide debacles such as this in San Francisco.

-- SS