EPtalk by Dr. Jayne 8/8/24
I like to stay close to my family medicine roots, so was excited to provide some local locum tenens coverage for a friend who was taking a much-anticipated vacation. Her practice uses an EHR that I’ve used to deliver patient care in the past, so I was confident in my ability to step in without a lot of retraining. Since I’m a new user on this particular system, I expected it would be a bit slow, especially since I wouldn’t have any medication favorites built and wouldn’t be terribly familiar with documentation templates in her particular system.
What I didn’t expect, however, was finding a defect that was recently injected into the system as part of an upgrade. In the prescribing system, the pick list that would normally be used to select how many times per day a medication should be taken had been morphed into something virtually unusable.
For an ambulatory medical practice, one would expect all of the “by mouth” options to be at the top of the list for easy selection. Instead, I was greeted by all the intravenous selections, followed by rectal and other options. The list also wasn’t responding correctly to keyboard inputs if I tried to do a type-ahead search, which meant that I had to scroll (and scroll and scroll) to write prescriptions. Needless to say, it was less than optimal for patient care.
I mentioned it to the office manager and she gave me explanation of it being upgrade related, so I can only hazard a guess at how many thousands of users are having their time wasted by this bug. It doesn’t impact physicians who primarily prescribe using a favorites list, so I guess I know what I’ll be doing this evening to make tomorrow less painful. Many newly trained physicians enter practice in July and August, so I bet I’m not the only one.
I also had the opportunity to attend a continuing education webinar this week. I was particularly excited about the session because one of my former medical students was presenting on an important clinical topic. I’ve presented on hundreds of webinars over the last decade, hosted by major academic institutions, medical societies, technology vendors, state health departments, and volunteer organizations. The best ones conduct a practice session or at least distribute a set of ground rules to explain how presenters should interact with each other and with the audience. When organizations don’t do this, sometimes they get lucky and everything goes well. In this situation they didn’t get lucky, however, as one of my friend’s co-presenters apparently didn’t get the memo to turn her camera off when she was not presenting.
Since there were only three panelists, their camera feeds were front and center. I’m assuming that her co-presenter was multitasking and looking at something humorous based on her facial expressions. Unfortunately, those expressions were occurring at a particularly sensitive point in the discussion that made it appear that she was laughing while serious patient harms were being reviewed. I’d like to assume that this was just an oversight on her part, and that she didn’t mean to be disrespectful, but either way it’s bad form. I hope someone at her organization recommends that she review the recording so she can see how she was projecting herself to the world.
I wish I would have run across this article earlier in the Summer Olympics hype cycle. Some of the parents of competitors were outfitted with heart rate monitors to see how their anxiety manifested as their athletes competed. NBC displayed data from the father of one of the US gymnasts during one of her routines. One would think that it would be enough to just display the facial expressions of loved ones since you can see every second of anxiety or amazement broadcast to the world already. Commenters on the article felt that displaying heart rate data was a bad idea, using words such as invasive, creepy, and unsportsmanlike to describe the practice.
Another article that I ran across this week detailed a physician who is accused of behaving badly by making over $1.5 million in personal charges on his business-issued credit card. The physician pleaded not guilty to the charges, with his attorney stating that “the funds he used were not stolen funds.” The card was used for $115,000 in cash advances, $176,000 in pet care, $348,000 in personal travel, $109,000 in gym memberships and personal training, $52,000 in catering, and $46,000 in tuition payments for his family. A savvy commenter called out the fact that he spent more on pet care than he did on his children.
The amazing thing about the situation is that the charges occurred over a seven-year period before being caught in an audit. According to the article, his institution is the only state-run hospital in New York City. One would think that being a public institution would make for stronger accounting controls. The physician is scheduled to appear in court again at the end of September.
Speaking of September: I discovered this week that the spelling and grammar checks in Microsoft Word will not catch “September 31” as something you shouldn’t type. It’s something I’ll be manually watching for in the future.
I wrote earlier in the week about the evolution of language and how that might impact large language models. I was excited to see this article about the forces changing language on a daily basis and that teenage girls are a major driver. It should be noted that the article is from Australia, which has its own unique linguistic offerings. Some of the experts interviewed in the article note that young women drive changes faster than young men and that this isn’t a new phenomenon – it has been studied extensively, including reviews of letters written from the 1400s to the 1600s. The fact that social media connects people from different regions and countries is also driving rapid change. One expert encourages people to place themselves close to a group of teenage girls to listen to how they communicate as a representation of where language is headed. I’ll be looking at my interactions with various community youth groups differently moving forward.
What do you think about changes in language and how they might be driven by social media or other societal forces? Leave a comment or email me.
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You described my weekend with mom.