The Four Letter Word                           

Here it is… My “epic” post. 

I’ve been waiting years to write this. Literally years. 

Ever since 2014 when I was required to attend 30+ hours of unpaid training for this new EHR, I knew this post would be written. I did have the option of 10 additional unpaid training hours to become a “gold star super user.” That status would have allowed me to teach every confused doctor in our office how to login and write their notes. Thanks, but no thanks.

I remember asking administrators “Why is it we need so many hours to learn how to write a SOAP note or document a CPE when we already know how to do that?” I never got a clear answer; just some blah blah babble about increasing efficiency and simpler, more accurate coding.  

It’s weird because I can’t remember training for any other electronic device that “simplified” my life (computer, iPod, phone or tablet). Do you? 

Focus Amy. Just write the blog. 

No one disagrees.  Medicine is a mess. Healthcare is chaotic, complicated, and expensive, so damn expensive.  There are plenty of problems to fix and enough blame to go around. One thing most doctors and nurses agree that has been bad for healthcare is EPIC, the EHR most large networks and hospitals have chosen to use. I’d go so far as to say that (and I’m putting this statement in CAPS for a reason) 

EPIC IS THE WORST ADVANCEMENT TO EVER BE INTRODUCED INTO MEDICINE.  

Let me explain why this is so. 

1)EPIC :  Every Provider’s Inefficiency Climbs    

Let me say first and foremost Epic is not built for physicians; instead it is built as a coding machine for profits. This EHR is the most cumbersome documentation tool for doctors ever. Click click click click. It never ends. Notes take longer than ever. The result? A bloated note, a 3 page strep throat note that now qualifies for a 99214 charge.  Many times I get a consult note from a specialist and I have no idea what he/she thought. The note is 14 pages of “stuff:” an outdated problem list, incorrect med list and an assessment and plan I can barely decipher. Did they think my patient had cancer? Did they need surgery or a biopsy? Was my differential diagnosis correct? Sometimes I can’t even tell…sometimes their note or summary isn’t even completed. I don’t blame them. I blame EPIC’s inefficiencies of documentation.

2) EPIC: Every Physician Ineffectively Communicates because Every Physician is Inputting Codes. 

This EHR has so many data entry requirements, so many demands for  physicians to check, that doctors rarely have time to communicate with their colleagues or patients. Back in the good ol’ days, ER docs called and told me a patient was admitted or treated. Cardiologists let me know my patient was recovering after an acute MI.

Gosh, we used to TALK about interesting cases. 

With EPIC … that all stopped. Everyone is too busy documenting, coding and whatever else is required.  Just get the right info entered in the right place with the right click so the higher charge can be entered.

Data data data.

I miss the days when real patient care and learning were higher priority for doctors. 

3) EPIC: Every Patient Is Confused. 

This is where things really get bad. Because of 1 and 2, because of EPIC, patient care suffers. 

Patients can’t understand why doctors are constantly looking at the computers, or making sure their “scribe” (we now need scribes!!!) gets the info entered. They can’t understand how to get a hold of their doctor. They can’t understand why it’s so hard to get an appt. Why they never get an answer to an email question. Why a Rx was sent in for them when no one explained the new medicine? Their care is given in silos, with very little communication between doctors and patients. Their care isn’t streamlined, it’s inefficient and choppy. I blame EPIC. (Well, there is enough blame for others. That will have to wait for another post) 

4) E. P.  I.  C. 

Whatever nemonic you choose…

EPIC is a 4 letter word. 

One of the most hated in medicine.

Prove me wrong.