Bigger and better than ever with more attendees than ever. Or I think that was the quote, or
close enough. Was it? I won’t question the attendees count. It was packed.
There was a refreshing start. Faces of Health Care, by Dr Andreas Laupacis, made us feel connected, starting at the source, back to what was important. That’s the way to start a teckie conference for physicians. Let us know, remind us, what we’re doing there. If you haven’t gone, take a break right now and visit this site: http://facesofhealthcare.ca/. Don’t think you have time? Look at the site, and forget this blog. You won’t regret it.
They could have started the day reviewing how much less financial support there is now for EMR. I don’t think it was mentioned. All day. Except out in the hall. It was mentioned there. Our group of 7 (much less inspired than that more famous group, but I like the sound of it…) physicians is looking at over $23,000 for merely software licensing next calendar year. We’ve managed to hold on to some of our monthly stipend, ending this year, and it will be probably enough to almost pay for it. For 2016. Minus any hardware hits. Which happen. I was born in a non digital age…I never thought computers could burn out so fast. We’ve got the best… all iMacs, but I guess all day use every day can even take down the mighty Mac. And with 12 exam rooms, 8 doctor stations, 3 nurses, and assorted support staff all on computers…But Hey, we would get EMR anyway, right? Quality in patient care over take home pay. Quality over lifestyle, quality over personal time.
That’s us, we’re physicians.
I found myself chewing the ear off of a patient OntarioMD rep about how much time all this takes. EMR, that is. Computers came out as the next great messiah. They were supposed to help efficiency, and they have. They were supposed to help us track things, stay on top of things, be complete, and they have. They were supposed to begin to enable us to look at what we’re doing critically, to improve what we’re doing, and they’re starting to. But what really made us all buy in? They were supposed to save time. And they’ve saved clerical time. It’s been clearly shown in multiple studies that the time savings with computers is mostly clerical. The time I spend now per chart compared to 30 years ago has mushroomed. What do I really come to these conferences for? Really? Yes, I want better patient care, YES. We all do, understand that. So do I. But maybe I come because I just want to get home.
Just get home. And unfortunately, all these great future things may just make us even later for dinner. Even later.
Is that being petty? Just wanting to go home?
Anyway. Next steps. I gather the focus of this conference was to try to move us along that continuum of digital maturity. The EMR: Every Step Conference. That’s what it implies. Some headway was made, I believe. One of my first talks was by Dr. Darren Larsen, the guy we all wish was in our clinic, the guy who actually seems to know what’s going on, who talked about the, “i4C” program, still in the works. Now this is what we’ve all been waiting for, or at least it sound like it. A process whereby up to date research, guidelines, and automated reminders come together seamlessly to help us at the point of patient contact. It just screamed, “longer time spent per patient,” but just think of the quality improvement possible! My spirit lifted, I could see over the clouds, the sunbeams were making me squint… until I realized it was all still pretty much theory. A horizon thing. Again. Crash.
I’ve always tried to reason with my aggravated, digitally burdened colleagues, urging them to have patience, my mantra being, “we’re a transition generation.” “We’re doing it for our interns, and medical students, we’re doing it for them, and their patients.” I’ve never really expected anything like this, “i4C”, in my practice lifetime. I’ve always felt that ours was the generation to shred the paper, to bring to life patient interaction with the EMR via tablets, to do online scheduling, goals that are still largely only vapors in my own clinic. Glimmerings of the start of qualitative studies are largely smothered by the burgeoning time commitment to chart maintenance. It seems we’ve all become high tech librarians, more than physicians. “i4C”? Well, if it comes, before I put down my stethoscope…We’ll see.
Then there was the raspberry pie. Or pi. Physicians trying to show their tips, things that have worked for them, or just trying to show what they’ve done, for little purpose it seemed…Some were too specific for a particular EMR… Then there was the tips and tricks session with software developers. That was probably more helpful than anything. I wish I’d spent longer there…
Sort of a dusty, sand running through your fingers experience. It all looked good on paper, started to sound good, then became granular, really nothing to hold onto. Inspiring, perhaps. Anything solid seemed to be illusional…
And then, just when hope was sinking, a magenta moment. There’s theory, and hope, and then there’s putting it into action. Remember the government’s several trillion dollar boondoggle trying to link up EMRs? And then Hamilton actually doing it on a shoestring?
Deep in Toronto there’s a little clinic with 7 or 8 docs, that have actually DONE something. Huge personal investments by this little clinic have spawned by the looks of it a solid patient scheduling system, a way of actually keeping examining rooms occupied, and something in evolution that just may allow us to keep track of outstanding/ missing lab results. Hopeful, enthused, clarity coming from young colleagues, speaking to a half empty room full of attendees to beaten up and exhausted to even respond.
For me, the sun finally broke through the clouds. And to think I almost left.
So maybe there was something, something solid. A solid step. My manager has called them. The yearly OntarioMD EMR conference. I’ve always come away with something.
I did this year, too.