Patients vs. Paperwork
When Hospital Paperwork Crowds Out Hospital Care by Theresa Brown (NY Times, December 20, 2015)
Excerpts:
In the age of electronic health records, computer documentation in health care has morphed into more than an account of our work; it has replaced the work itself.
In home hospice, where I now work, the documentation is even more onerous than in the hospital and seems even more disconnected from actual patients. Hospice care is a covered benefit under Medicare, and the Centers for Medicare and Medicaid Services maintain rigid standards for documentation. They regularly withhold reimbursement if documentation is deemed incomplete or flawed.
Charting a hospice admission usually takes between two and four hours, and requires filling out a seemingly endless number of data fields — some of them defying logic.
Electronic health records present an enticingly clean and clear vision of clinical work, whereas real patients are messy, confusing and unpredictable. Sadly, all the attention given to our paperwork is taking us further and further away from the difficult truth that meeting very ill patients’ needs occurs in real time with real people, not in the paperwork about them.
Goethe wrote: “In the end, we are dependent on creatures we have made. “ This sad truth underlies Theresa Brown’s excellent Op-Ed piece on Patients vs. Paperwork.