Paper Versus Computer
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Notes from a doctor with a laptop, a housecall bag and a fountain pen. Day-to day and career reflections from a 1979 Medical School graduate practicing on Maine's Canadian border.
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Paper Versus Computer
Just look at this and weep!
This is from a 2022 post on my WordPress blog. The first picture is my paper warfarin dosing sheet. Each test value with its new dosing instructions uses up one line. The second picture is the EMR workflow in Epic for EACH AND EVERY time a patient gets tested and needs dosing instructions. And this is progress???
I rest my case. No further questions, your Honor…
Paper Versus Computer
I used EPIC for 5 months before I retired in 2019 at 65 and 1/2 years of age. I did not like it or the Allscripts we had before it, but I learned to make each one work for me. I showed this blog to my son who is a 40 year old family doctor. He practiced for 10 years on the Navajo Reservation at Winslow and now is a family doctor on the east coast and practices and teaches in a family medicine residency program. Since his med school days he's known nothing else but the EHR and over his career has probably used 4 or 5 or even more different programs. He's had his aggravations with EPIC. That being said he told me he very much likes the EPIC PT/INR flow chart stating "it’s pretty nice, prints out a calendar with the dose and how many of each tab to take per day." He goes on to add "I’d argue a better question is why does (the) American healthcare (system)still force us to use warfarin in 2023 (with the exception of mechanical heart valves and antiphospholipid syndrome)?" Why indeed. Eliquis here in the U.S. is over $500 per month. In Germany it is less than $100 per month. That would still be a stretch for a lot of Medicare patients. The CEO of Bristol Myers Squibb recently wrote an editorial in the Wall Street Journal where he claims that "Seniors on Medicare pay, on average, $55 per month for the drug." What planet is he on? He truly has no idea. He probably has never set foot in a pharmacy or gotten mail order prescriptions in his life. I have a stake in this personally as I'm on Eliquis. It is a 3rd tier drug for me in spite of at least 3 huge studies showing that it is far and away the most effective and safe drug, when compared to warfarin, for atrial fibrillation. Oops...due for my pm dose.
No wonder so many doctors are exhausted and vexed. Now, how can patients advocate for change for the our doctors?