Since the computer was open anyway, I clicked the EMR icon and waited to connect to the database thousands of miles away. The sun was setting on the pacific and a half empty Corona sat on the table next to my pool chair. My mind was relaxed. The kids splashed in and out of the water as a Mariachi band played in the background.
Within moments, the idyllic surroundings faded and I was back in my office. The inbox was full and I scrolled through the messages. Mrs. Jones was having urinary symptoms again. I rattled off a note to my medical assistant and eprescribed Cipro to her pharmacy.
Apparently Mr. Thomas was in the hospital. A few more clicks and I was perusing the inpatient chart. He ran out of meds again and forgot to fill the diuretic. I scrolled over his med list. Just as I expected, no one restarted his Digoxin. I jumped into the physician order entry page and added the medication. I shot a quick email to my partner to let him know that I had been in the chart.
I spent the next thirty minutes taking care of patients from a distant beach in Mexico. I placed phone calls, ordered CT's, and prescribed medications.
And for a moment I pictured the perfect life. Plying my trade with the latest technology from paradise. All I needed was my knowledge, and internet connection, a mobile phone, and a highly developed electronic medical record.
Ofcourse, unlike so many involved in the transformation of healthcare, I knew that this notion was just a fantasy. The bells and whistles may make the delivery of care more convenient, but they are not an end unto themselves.
We can measure quality based on clicks and ticks. We can denigrate whole systems based on their ability to comply, to meaningfully use the technology that is foisted upon them.
Or we can accept that healing takes place face to face, hand to hand, when the computer screen is ignored,
and we start listening to our patients.
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