Simple technology for complex work
Simple technology for complex work
Given the complex tasks of the physician scribes at Tri-City Medical Center in Oceanside, CA, you'd think that the technology they use to interface with the department's electronic medical record (EMR) from Cerner Systems would be anything but user-friendly. After all, the scribes use electronic tablets, go to the bedside with the doctor, and document everything in real time using their tablets in such a way that by the time the doctor walks out of the room, the history and physical are completed. The doctor then enters all their orders by computerized physician order entry (CPOE), while the scribe tidies the chart at the workstation, to which their tablet docks.
They pull in all the labs, imaging, and old studies that are pertinent. They can pull prior personal medical history and social history. They can document procedures done using the system templates, pull in discharge medications and discharge instructions, and by the time the patient leaves, the chart is completed.
But the technology is "not difficult at all," according to Reid F. Conant, MD, FACEP, chief medical information officer at Tri-City Emergency Medical Group, IT physician liaison at Tri-City Medical Center, and president of Conant and Associates, an independent IT consulting firm also based in Oceanside. "It's very easy," he says. "The tablets have 12-inch screens. They're light and portable, and they can dock them at a desktop and type information using the keyboard."
The tablets are not expensive, adds Gene Ma, MD, FACEP, chairman of the Department of Emergency Medicine and assistant clinical professor at the University of California San Diego School of Medicine. "Although they are integrated with Cerner, we bought them separately from Research in Motion [based in Waterloo, Ontario, Canada], and they cost about $1,800-$2,000," says Ma. He has purchased enough to have one per scribe per shift, or six in all. However, he adds, "there are others you can get for less, including Dell's, which are about $1,200, so we may be switching."
The scribes' integration into the ED is eased by a six-week training program provided by Lancaster, CA-based Scribe America, which also handles the recruiting. "For us, it's pretty seamless," says Conant, who notes that the total cost of annual training is $350,000. However, he adds, "The cost of dictation was $2 million a year before we started [the scribe system]." After a six-week training program, the scribes go through a few shadow shifts where they follow other scribes, before they go live.
As for the scribes themselves, says Ma, he has no difficulty recruiting them. "We have pre-med students from all over the area eager to get on the waiting list to work in our setting, as they realize what a fantastic and unique opportunity it is to gain invaluable insight into the medical realm, and they love it," he says.
Given the complex tasks of the physician scribes at Tri-City Medical Center in Oceanside, CA, you'd think that the technology they use to interface with the department's electronic medical record (EMR) from Cerner Systems would be anything but user-friendly.Subscribe Now for Access
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