I’ve been distance running for more than four years now and have completed 30 races, including two marathons. This year, I decided to branch out a bit and compete in my first triathlon — a race where I will swim, bike and then run.
The preparation and training have been much more difficult than I anticipated. I have had to find time to fit three sports into my training schedule. There was new equipment to purchase and aches and pains in different muscles.
Most importantly, I’ve learned that a critical component of the triathlon is the transition between each sport. A triathlete must learn how to move quickly and efficiently from one activity to the next without stopping to think or rest for very long.
Transitions have been on my mind quite a bit lately. At long last, our office is transitioning to electronic health records (EHRs) this fall. I’ve been very excited about this change for a while, as I feel our system of paper charting is somewhat antiquated.
But as this transition looms on the horizon, the practical realities of implementation are sinking in. I’m beginning to dread the process of changing over, and how EHRs will change the way I practice midwifery.
Each patient’s complete medical history, as well the current visit information, will have to be entered into the new system. This data entry will not only cut into productivity, but more importantly into actual patient interaction time. I’m afraid I’ll be so engrossed in learning to use the new software and entering all the information properly, that I’ll miss important nonverbal cues and messages that I count on as a crucial piece of my assessment.
I worry that when we implement the EHR, we will lose valuable aspects of human interaction with our patients. In my paper charting, I tend to make notes about what is happening in women’s lives when I see them each year. This helps me remember more about them than last year’s Pap smear results, and helps my patients feel like more than just a number in my day.
Sometimes arriving at the big picture in health care involves more than simply assessing vital signs and medical history. You need the patient’s story, and I’m learning that is not so easy to write or read with an EHR.
There are many components of the transition to the EHR that are going to drastically change the way our practice functions, from alterations in physical space to availability of past lab results and imaging reports.
Similar to my transition from runner to triathlete, I’m trying to maintain my initial excitement and remain undaunted by the stress of the transition process. I’m seeking out positive feedback from other EHR users and amassing tips and tricks to ease into the change.
I don’t think it will be easy. I know it will be somewhat painful. But in the end, I hope that I will be able to provide my patients with better care using EHRs.
Robyn Carlisle, MSN, CNM, WHNP, works as a full-scope midwife at University Doctors and Kennedy University Hospital in Sewell, N.J.