fbpx

Clinical Practice in the Digital Age – A Difficult Transition.

Published by cathalmalone@hotmail.com on

[av_textblock size=” font_color=” color=”]

Clinical Practice in the Digital Age – A Difficult Transition.

Practice management systems have been around for a number of years and many private clinics effectively run their businesses through utilising the diary, billing and reporting features provided by these systems. However, many clinics still remain paper heavy with the primary reason being that clinics are struggling with the move to converting their current clinical notes from paper to a digital form.

Administration and clinical notes have historically been paper based in healthcare. Paper notes hold a familiarity to most clinicians and many feel that this is the simplest and best way to record a patient’s medical history. However, paper notes come with many draw backs:

[/av_textblock]

[av_three_fifth first min_height=” vertical_alignment=” space=” custom_margin=” margin=’0px’ padding=’0px’ border=” border_color=” radius=’0px’ background_color=” src=” background_position=’top left’ background_repeat=’no-repeat’ animation=”]
[av_textblock size=” font_color=” color=”]

  • Cumbersome and costly to store,
  • Easily misplaced or lost
  • Information is timely to record
  • Hand writing is frequently illegible
  • Countless hours of administration time is lost to organising files for clinics
  • Important clinical data can also be difficult to obtain from lengthy medical notes
  • Analysis of service provision is troublesome

[/av_textblock]
[/av_three_fifth]

[av_two_fifth min_height=” vertical_alignment=” space=” custom_margin=” margin=’0px’ padding=’0px’ border=” border_color=” radius=’0px’ background_color=” src=” background_position=’top left’ background_repeat=’no-repeat’ animation=”]
[av_hr class=’invisible’ height=’50’ shadow=’no-shadow’ position=’center’ custom_border=’av-border-thin’ custom_width=’50px’ custom_border_color=” custom_margin_top=’30px’ custom_margin_bottom=’30px’ icon_select=’yes’ custom_icon_color=” icon=’ue808′ font=’entypo-fontello’]

[av_textblock size=” font_color=” color=”]

‘Paper notes hold a familiarity to most clinicians and many feel that this is the simplest and best way to record a patient’s medical history’

[/av_textblock]
[/av_two_fifth]

[av_textblock size=” font_color=” color=”]

The world is heading in one direction and it is one based around technology. The use of technology in modern healthcare is increasing and this is reflected by the greater number of services implementing patient management software into its day to day use. Electronic patient records systems are viewed to have the potential to bring huge benefits to patients in that storing and sharing health information electronically can:

  • Speed up clinical communication
  • Reduce clerical support
  • Reduce the number of medical errors
  • Assist clinicians in diagnosis and treatment

[/av_textblock]

[av_one_fifth first min_height=” vertical_alignment=” space=” custom_margin=” margin=’0px’ padding=’0px’ border=” border_color=” radius=’0px’ background_color=” src=” background_position=’top left’ background_repeat=’no-repeat’ animation=”][/av_one_fifth]

[av_three_fifth min_height=” vertical_alignment=” space=” custom_margin=” margin=’0px’ padding=’0px’ border=” border_color=” radius=’0px’ background_color=” src=” background_position=’top left’ background_repeat=’no-repeat’ animation=”]
[av_textblock size=” font_color=” color=”]

‘Most clinicians feel that the right type of electronic notes system is not yet available’

[/av_textblock]

[av_hr class=’invisible’ height=’10’ shadow=’no-shadow’ position=’center’ custom_border=’av-border-thin’ custom_width=’50px’ custom_border_color=” custom_margin_top=’30px’ custom_margin_bottom=’30px’ icon_select=’yes’ custom_icon_color=” icon=’ue808′ font=’entypo-fontello’]
[/av_three_fifth]

[av_one_fifth min_height=” vertical_alignment=” space=” custom_margin=” margin=’0px’ padding=’0px’ border=” border_color=” radius=’0px’ background_color=” src=” background_position=’top left’ background_repeat=’no-repeat’ animation=”][/av_one_fifth]

[av_textblock size=” font_color=” color=”]

It would be assumed then that the potential benefits of electronic systems versus the many negatives of paper based administration would have resulted in a substantial uptake of electronic patient management systems in healthcare. This however, has not been the case. The overall use of electronic note taking systems has been found to be less than 15% in Orthopaedic clinics, with the primary reason being that most clinicians feel that the right type of electronic notes system is not yet available.

[/av_textblock]

[av_one_third first min_height=” vertical_alignment=” space=” custom_margin=” margin=’0px’ padding=’0px’ border=” border_color=” radius=’0px’ background_color=” src=” background_position=’top left’ background_repeat=’no-repeat’ animation=”]
[av_hr class=’invisible’ height=’50’ shadow=’no-shadow’ position=’center’ custom_border=’av-border-thin’ custom_width=’50px’ custom_border_color=” custom_margin_top=’30px’ custom_margin_bottom=’30px’ icon_select=’yes’ custom_icon_color=” icon=’ue808′ font=’entypo-fontello’]

[av_textblock size=” font_color=” color=”]

‘Paper notes hold a familiarity to most clinicians and many feel that this is the simplest and best way to record a patient’s medical history’

[/av_textblock]
[/av_one_third]

[av_two_third min_height=” vertical_alignment=” space=” custom_margin=” margin=’0px’ padding=’0px’ border=” border_color=” radius=’0px’ background_color=” src=” background_position=’top left’ background_repeat=’no-repeat’ animation=”]
[av_textblock size=” font_color=” color=”]

Although paper notes come with many drawbacks, many clinicians have strong opinions that the use of computers hinder their daily tasks rather than enhance their day to day workings. Many feel that current healthcare software packages are inefficient and do not provide the necessary tools to effectively complete their clinical roles. Clinicians and administrative staff are commonly faced with increasingly complex computer applications. Many clinical staff are often bewildered by the vast array of configuration options and operating modes supported by computer based systems, while manufacturers often feel compelled to offer more and more software features to retain market position. These factors combine to create “usability” problems that have had a direct impact on patient outcomes.

[/av_textblock]
[/av_two_third]

[av_textblock size=” font_color=” color=”]

A further reason for the lack of uptake has been identified as being that clinicians have always recorded their patient assessments/ treatments with pen and paper and that the current drive to move to a ‘paperless’ healthcare service is a concern for many clinicians. Assessing patients is a skill that clinicians develop over many years in order to complete a thorough examination in a timely fashion. When an alien task (i.e. typing notes) is now expected to be performed then it is clear that some aspect of the patient’s assessment will suffer. Implementing electronic note taking software into healthcare has been shown to create inefficiencies in service delivery (Rotherham NHS trust) as clinicians struggled to complete their assessments in their allotted time due to their lack of typing skills.

[/av_textblock]

[av_one_fifth first min_height=” vertical_alignment=” space=” custom_margin=” margin=’0px’ padding=’0px’ border=” border_color=” radius=’0px’ background_color=” src=” background_position=’top left’ background_repeat=’no-repeat’ animation=”][/av_one_fifth]

[av_three_fifth min_height=” vertical_alignment=” space=” custom_margin=” margin=’0px’ padding=’0px’ border=” border_color=” radius=’0px’ background_color=” src=” background_position=’top left’ background_repeat=’no-repeat’ animation=”]
[av_textblock size=” font_color=” color=”]

‘It is often reported by patients that they felt their clinician appeared more focused on their computer than their problems’

[/av_textblock]

[av_hr class=’invisible’ height=’10’ shadow=’no-shadow’ position=’center’ custom_border=’av-border-thin’ custom_width=’50px’ custom_border_color=” custom_margin_top=’30px’ custom_margin_bottom=’30px’ icon_select=’yes’ custom_icon_color=” icon=’ue808′ font=’entypo-fontello’]
[/av_three_fifth]

[av_one_fifth min_height=” vertical_alignment=” space=” custom_margin=” margin=’0px’ padding=’0px’ border=” border_color=” radius=’0px’ background_color=” src=” background_position=’top left’ background_repeat=’no-repeat’ animation=”][/av_one_fifth]

[av_textblock size=” font_color=” color=”]

Many clinicians do not possess strong typing skills and subsequently the standard of patient notes diminishes. In the modern age of increasing litigation within healthcare there is in fact a greater need for clinicians to be able to prove and record all their clinical decisions. In order to tackle this issue we believe that developing a software system that will allow clinicians to maintain the usual high standard of note taking is very important.

A further common problem identified in modern healthcare is the effect that electronic note taking has on the interaction between the clinician and patient. It is often reported by patients that they felt their clinician appeared more focused on their computer than their problems. The importance of creating accurate medical notes in tandem with a struggling typing clinician is reported to have become a common occurrence within many modern day patient consultations.

[/av_textblock]

[av_three_fifth first min_height=” vertical_alignment=” space=” custom_margin=” margin=’0px’ padding=’0px’ border=” border_color=” radius=’0px’ background_color=” src=” background_position=’top left’ background_repeat=’no-repeat’ animation=”]
[av_textblock size=” font_color=” color=”]

To have an accurate electronic patient record however, will ultimately require clinicians to have an effective platform on which to record their patient’s notes. Current software is felt to primarily cater for the administrative needs of a health service, with their clinical usefulness being often questioned. Such negative views will be hard to change and with the inevitable increase of computer use within healthcare indicates that future software development must consider the needs of its primary users. Literature has repeatedly identified that clinician involvement is vital for the successful implementation of a digital healthcare system however in so many cases it has been found that, clinicians are one of the last groups to be consulted when implementing a new process or system.

[/av_textblock]
[/av_three_fifth]

[av_two_fifth min_height=” vertical_alignment=” space=” custom_margin=” margin=’0px’ padding=’0px’ border=” border_color=” radius=’0px’ background_color=” src=” background_position=’top left’ background_repeat=’no-repeat’ animation=”]
[av_hr class=’invisible’ height=’50’ shadow=’no-shadow’ position=’center’ custom_border=’av-border-thin’ custom_width=’50px’ custom_border_color=” custom_margin_top=’30px’ custom_margin_bottom=’30px’ icon_select=’yes’ custom_icon_color=” icon=’ue808′ font=’entypo-fontello’]

[av_textblock size=” font_color=” color=”]

‘Clinician involvement is vital for the successful implementation of a digital healthcare system’.

[/av_textblock]
[/av_two_fifth]

[av_textblock size=” font_color=” color=”]

Written by Cathal Malone,

MSKnote Company Director

“This is why MSKnote is unique – clinical staff have developed the platform from which they will work from and so the necessary tools are available. This will not only aid the transition from pen and paper to electronic note taking but will ultimately allow clinicians to perform their roles more efficiently and in turn improve patient care”.

[/av_textblock]

[av_hr class=’invisible’ height=’20’ shadow=’no-shadow’ position=’center’ custom_border=’av-border-thin’ custom_width=’50px’ custom_border_color=” custom_margin_top=’30px’ custom_margin_bottom=’30px’ icon_select=’yes’ custom_icon_color=” icon=’ue808′ font=’entypo-fontello’]

[av_social_share title=’Share this entry’ style=” buttons=” share_facebook=” share_twitter=” share_pinterest=” share_gplus=” share_reddit=” share_linkedin=” share_tumblr=” share_vk=” share_mail=”][/av_social_share]

[av_comments_list]

[av_postslider link=’category’ columns=’3′ items=’9′ offset=’0′ contents=’excerpt’ preview_mode=’auto’ image_size=’portfolio’ autoplay=’no’ interval=’5′]


Leave a Reply

Your email address will not be published. Required fields are marked *