@eugiboy1 This is a PTSD training video for the IT people and the super users😬. I really feel bad for IT some days😔. I work with some people who hit the enter button a thousand (not literally but way too many) times in a row, and then wonder why the computer is slow😂.
ROFL. I Agree... the whole "it's your username and PW" how do you mess that up??? (however, there WAS that bug a few years ago where once in a while everything you typed in the epic login screen acted like the shift key was pressed....
@@incalescent9378 My guess is an attempt at error checking to make sure caps lock isn't on, but accidentally turned it on instead of just check. My question unrelated to epic is why once when a computer wouldn't boot I saw the error message "Power on self test failed because power on self test passed."
Haven't seen epic-use powerchart (or at least a very old version of it -- execs saving $$$ and all). Has anybody ever considered the user interface is the problem?
At least the doc in the video knew how to double click! Trying to help my (usually older) coworkers, I tell them to double click on something. Coworker: I clicked on it. It didn't work. Me: No, Sue, you need to double click. Coworker: ..... Me: Okay, just click twice in a row. Like clickclick. Do that. Coworker: Click. ... Click Me: No, really fast. clickclick! Like that. Coworker: CLICK. .. CLICK Me: No, not harder--you have to click the mouse faster. Coworker: Why is it even called a mouse? They should just call it a clicker-- that's what you do with it. Then again, the clicker is the name of the TV control, so I-- Nurse Manager [pops out of her office]: So how're we doing? Are we almost at 100% proficiency for the unit?
Priceless. My department alone had 3 docs retire solely because they didn’t want to learn epic. A couple more just went and got a job at a hospital not using epic. One of them literally stood up an hour or two into the agonizing experience that is “epic training sessions” and walked out the room, never to return. Submitted their retirement to start the day before the live epic roll out. Our hospital also decided the best timing for epic roll out was a week before all the new interns started 🙄
Making the transition coincide with new interns makes way more sense than spending time training them on the old system and then swapping to the new one and having to start over.
@@fakjbf3129 True, but if everyone had only be using it for a week, that's not good to be teaching the interns about it. Perhaps should have switched over a bit earlier, lol.
I’m surprised they knew how to doubleclick! Retirement age people always seem to think clicking once. Then waiting 5 years and clicking again is doubeclicking
That's not just retirement people. One of my professors does the same. I do not understand how this man gets anything published the way he interacts with software.
@@DeathnoteBBOh yeah, that happens too. My elderly dad complained that "the icons on the computer kept moving". That puzzled me so I drove over. And when I saw what was going on it of course all made sense: click, hold, move the mouse, release, click again - and now the icon is somewhere else. 🫥 I taught him to (single!) click the icons I moved to the taskbar, problem (mostly) solved.
My hospital system switched to Epic a few years ago. For a brief moment, all departments were patient and understanding with each other and focused our disdain towards IT.
No, but they can threaten you by telling you that if this system fails then it will be your fault that people die. And the lengths they will go to to ensure everyone knows who is at fault.
I have always thought that a fight among physicians must be especially brutal and literally abattoir-class carnage since they know where all the arteries, major nerves and ligaments are that hold everything together are intuitively, and some of them wield surgical steel knives all day long anyway.
The sheer glee with which my mom informed me that her retirement date came before the department was due to switch over to Epic suddenly makes a lot more sense 😅
If you were in your 60s or older in 1990s, you will have a hard time with electronic stuff. Whenever I see that a pt is older than 76, I automatically assume that they dont use MyChart, no matter what their chart says.
I was a tech writer at a hospital that used a mainframe program (written in house) to manage patient info. Not med refs yet, this was in the early 90s. We rolled out a new feature that let doctors print out the list of patients they had to see that day. Very easy to do, and I wrote a simple how-to sheet that was kept next to each computer in the doctor lounge. Then I got a demand from some doctors that they needed a clerk to sit there and get their lists for them because it was too hard. The biggest complaints came from surgeons, they didn’t even try. Of course no clerk was going to appear, so I decided to make it even simpler. Instead of telling them to press a function key, I glued colored dots on the relevant function keys on each keyboard in the doctor lounge and rewrote the instructions. Instead of “press F1 to (do this)” it was “press the red key to (do this)” and added a red dot after the words “red key”. This apparently did the trick for the surgeons. These instructions were five steps, and we had to color code them for the guys with the scalpels. Did not give me a lot of confidence in them.
When I was a tech writer in software development, our boss's remark about color-coding and writing *to* your audience instead of *at* them was, "eliminate excuses" when he was feeling testy, and "eliminate barriers" when he was feeling kind (rarer lol). He would have thoroughly approved your approach 😂 I can give a little insight into why those bonehe-- er, surgeons handled that so badly. It's about brain wiring. If it doesn't bleed and they don't have a 3-d space to work in, their logic circuits can't engage. I know you know that -- it was just fun to write 😊
Their brains are so full of keeping up to date on every new journal paper submitted every year, memorizing it, and each new surgical procedure it entails that they don't have any more RAM to decode number and letter stuff.
This was all further complicated by the fact the hospital was moving away from dumb terminals to PCs, which meant I had to include instructions on how to use a mouse. The horror! Nurses hated the PCs because they took up too much room on the charge desk with that separate keyboard, mouse, and mousepad. It was nothing like learning EPIC but was still a huge change for everyone. And change is hard!
I used to work for an EMR company that competed - or failed to compete - with EPIC. The basic problem was that EPIC started as a back office thing, and grew out to include the doctors, while we were trying to go in the opposite direction. Turns out Doctors make very few decisions at hospitals, and the back office forces them to use a tool that kind of sucks for actual medicine but makes the back office's job easier.
This hits the nail on the head. The EMR is designed for billing and liability protection, not for facilitating good communication between providers (although you'd think that would be a component of liability protection), ease of use, user satisfaction, etc.
every update seemed to make it easier for someone else (billing etc) but required more clicks and documentation from the front-line workers, which takes more time away from face-to-face interaction with the patient. There are things I liked about EMRs (like not having to walk around the ward looking for who had the chart), but there were times when attention to important patient care was divided because EPIC needed attention -- and if you didn't give EPIC the attention it needed at that moment it just created more work later.
“The nursing flowsheets? You do not want to open that Pandora’s box.” As a nurse using epic (or any EMR)…. Thank you. 😂 The amount of time I waste charting is astronomical.
I was a librarian at a medical center teaching searching medical literature. We had to have separate classes for the doctors and nurses because the doctors didn't want anyone to know they didn't know something.
As an RN, I can attest to the fact that the surgeons may indeed need specific instruction that violence is not the answer. I once had a GI doc literally throw an office chair at me in the public area of the nurses’ station bc their pt had refused to finish their GoLytely. Then he promptly went to HR to file an insubordination complaint against me, bc somehow as charge nurse, it was my fault that he had “lost his temper”. I was formally reprimanded for “antagonizing a valued physician”. Ah, the dark ages of the 90’s.
Yes but at least you have been trained to work at Waffle House now... PS my mom is an RN and I can't imagine anyone even in the Green Berets daring to throw a chair at her...
My wife is a nurse. I'd have promptly driven to that hospital and met Mr. butt doctor in the parking lot after his shift and had a polite discussion about whether he'd like to have his own colonoscopy using my foot if he threw anything at my wife again.
Not my opinion, but based on my almost 50 years of actual work experience, that behavior, where the doc threw a chair, is a guy thing, and not just on the part of arrogant physicians. I'm the only female in my current workplace. There was the time when three of my male "colleagues" ganged up on me to go home, because one of them came to work on his off day, didn't feel like leaving, and he wanted my hours. Of course, I said hell no. A week and a half later the head of HR showed up and blamed ME, for what I still haven't figured out. There were a few more similar incidents. I like the job itself and I waited them out until they finally figured out my complete disdain for their tactics and that I was never ever going to cave. Guys pull this crap simply because they can. It's been years since my divorce from a cheating and abusive spouse. On several occasions, since the divorce, I've either been approached in a chance meeting in a retail store, or received actual telephone calls, from his friends and even one family member, who apologized for not speaking up on my behalf during the marriage, freely admitting that they felt that although they wanted to say something, they couldn't because either he was family or they had known him since kindergarten. Gee, thanks for the apology. There was the time that I kept a well documented record in a previous job for months about the antics of a male supervisor. Women were quitting because of him. I went to his manager with my journal and within months he was gone. I'm not making this up. I like men but I'm so tired of the crap some of them get away with, simply because they can. Now in my lady geezerhood I don't hesitate one second to forcefully call them out on their bs. This is a long post. Probably no one will read it, but if you do, whether you're male or female, if you recognize this stupid behavior either in yourself or a co-worker, please don't accept it. Most of our waking lives are spent at work, and no one should have to go home every night dreading the next day simply because of a colleague's unacceptable behavior.
@@karens1967 I read it. There's no excuse for that kind of behavior from anyone, regardless of status, but some people will do whatever they think they can get away with when they believe there will be no consequences. On the other hand, a lot of people like that are also afraid of being challenged and/or having their behavior brought to public attention and will only do what they think they can easily get away with without notice by their peers or resistance from their target, but I know personally how that's easier said than done for people who have a timid personality or have been abused in the past. I'm male, but I grew up as an intelligent fat kid in a hick town that didn't appreciate anyone who stood out or was different in any way, and was bullied physically and emotionally from the time I was a young child until I reached adulthood, when I had finally had enough and began fighting for myself because I knew no one else was going to. It's good you no longer take anyone's crap. That goes a long way to shut down that kind of behavior. Sorry you had to endure all of that for so long in your life.
@@karens1967 the men get violent. The women play psychological warfare. I had a female coworker openly hate me and say I didn't do my job. Even went as far as going to other locations and telling them I was incompetent. I went to my manager several times and he would reprimand her and she would go to his boss to complain about that. Even went so far as to refusing to talk to me and only interacted via sticky notes. She wanted me to quit. This probably makes me sound like a horrible coworker but I'm really not. No one else has a problem with me and no one couldn't figure out why she hated me. We do have male patients who try the intimidation/violence tactic though. Not actually becoming violent towards me but smacking the counter and knocking over things. They never expect a tiny 5'4 girl to stand up to them and say no. My manager says I inherit the problem patients because I look so sweet and innocent lol
My Epic IT lady cried the first day bc I was trying reorder a lab for the first time on a silent infant code and even she was having trouble getting what I needed. They called it: so I told her never mind I didn’t need the order. She didn’t understand so I explained what “they called it “ meant. no IT training prepares you for that .
@@fredericapanon207 that's right, although i dont think that that lab result would've done much to save their life at that point, theyre too time-consuming even if it's stat
I'm not even a medical professional and I felt my soul die. I have heard people talk about the switchover, I've had problems as a patient, I know someone who's a trainer... And one day, in the ER, I noticed the user and password was the same and taped on every station. While I was chilling, an IT bro came to educate everyone on some change and to tell at them about not using their own logins. The staff showed polite acceptance and they were absolutely not going to stop using the same account to log in. They should let them scan a bar code like at CVS.
Smart cards for the win here. Much more secure than barcodes. It's the same chip in your credit cards, insert and leave inserted for access, and then when you remove it it auto logs out. All the benefits of easy access while harder to hack and more secure.
Depends on the facility, but if they pay for badge scanners then just swiping your badge allows you to login. The pain and comedy comes mostly from underfunded transitions trying to use patchwork systems. (One user logon for just one system costs $5,000, if I remember correctly from my time at the biggest healthcare org in the US).
EPIC does allow NFC/smart card logins (better than barcodes, and actually more secure than passwords). My local hospital systems exclusively use this system, and for the doctors they literally just tap their ID badge to the computer and bam, their logged in.
Okay but I work at CVS, and it's actually a combination of logging in with a username and password AND scanning our credentials (the barcode). Also I have a feeling the system we use is simpler than Epic, but I don't think we do as much as a hospital, which is why we don't need it
As a surgeon who was an Epic super user and is now subjected to two inferior EMRs (Athena and Meditech) that don’t talk to each other. I laughed but then I cried tears of wanting.
Agreed. As a dietitian, I used a lot of different EMRs at different sites during training. Very glad I ended up with Epic! After the initial learning curve all those smartlinks really do come in handy!
This. I've used many EMRs throughout med school, residency, fellowship, and attendinghood, and nothing comes close to Epic in design, customizability, and functionality.
Me when we switched to Cerner. Why the hell does there need to be PowerChart AND RevCycle? Why do I have to remember to refresh every 10 minutes to not miss an urgent message? WHY DO I HAVE TO FILL OUT A MICRO ROI FOR MYSELF WHEN I'M JUST TRYING TO PRINT A DAMN OP REPORT? 😭
I won’t ever forget the sales demo when Epic came in and showed the billing staff how they could click on a link on the bill and the precise item that generated the charge in the chart was displayed. The room erupted in whispers and not so whispered comments. I happened to be standing by our CIO in the back of the room. We looked at each other and said- that sold the system. The people from Epic had suitably discrete grins. We went live in 2006.
One of my questions when interviewing for residency is “What EMR do you use?” And then I sigh with relief when they say Epic. I don’t think I can use anything else permanently. Any other EMR makes me angy 😂
As a patient, watching the lab technician click through EPIC has always given me mad respect for them. As the only IT tech at a small college I feel the pain of both adopting and training people on systems. Especially for logins.
You know, when the wards can't cope with their new programs they call the lab as if we were some IT wizards...? It's because they can't get hold of any of the actual IT guys...
@@katarzynajakubiec3566Right? We were told by the nurse coordinator that it was our fault the daily vanc wasn't drawn on the inpatient because we didn't go through every inpatient's chart every morning. When it was they who ordered it wrong so it didn't show up all week.
@@fyrestormebecause there's no money in it from a management standpoint. That's why internal tools are the worst about it too, they know people are going to have to use it no matter how bad the UI is as long as the base functionality is there. Why spend an extra 40 hours of dev time making a user friendly UI when you'll sell the same number of units with a barely functional UI and save hundreds of dollars?
@@fyrestorme arrogance is part of it. It works for them, they think they are right, and anyone not 'getting' it is just dumb and you can therefore dismiss their complaints. (The other thing is that actually good UX is hard, especially when you have to fit so many contrary needs, in essence: what's easy to put down is usually not easy to access or find later on - this has been hard from the beginning of charting and will always be hard: how can you make access to useful information easier without making entry harder? How can you help and catch mistakes while not being in someone's way? Some of those things are truly hard to solve and will always have friction. A lot of it is just bad design though.)
Ooof my lab is switching to epic in 2 months. I can just imagine how this is gonna make my days longer. Especially since I'm the youngest and newest person in the lab. I worry for my senior techs.
I love how everyone who complains about Epic is so sweetly naive about the horrors that are eCW, meditech, and every other subpar EMR that doesn’t communicate with anything else. Dr. G with another incredible video capturing the horrors and hilarities that are EMRs, please do more! Ps - on our go-live day at my small community hospital, all the epic support staff wore Hawaiian shirts so we could easily flag them down for help 😂
I get that it wasn't great for nurses and maybe some other areas, but as a lab/x-ray tech I miss meditech, even though I love a lot of things about Epic. It was so simple, straightforward, and we didn't need to use 5 other programs just to do our job that meditech did just fine on its own.
Epic is such an odd piece of software. It’s like…good, but simultaneously…bad. Finding things is really odd. In fact the Epic people have been telling us to just use the search function to type in what you want to do lol.
I worked IT for a pharmaceutical company and they would occasionally send their trainee reps to my department for supplemental training on how to get the presentation software they used to play nicely at the locations they were doing whatever it is a pharmaceutical rep at a lens bank or hospital does. I ended up making my own guides using screenshots and awarding chocolate to anyone who actually read the document. Anything involving locations that used Epic and I’d break out the boozy truffles afterwards. It’s the closest IT can get to offering anaesthetic.
“That’s where you’ll find more work when you’re done with your work“. This was one of the driving forces that pushed me into Radiology. Now we’re about to get a new PACS…need to remind myself of the no physical violence against IT rule.
My father was an airline pilot captain from 1951 to 1984; he flew by the seat of his pants, very physical. At the end of his career computers were showing up in the cockpit more and more. At first he could cope, but before he retired he was struggling. He never trusted them, only his own mental and physical abilities. As much as he passionately loved flying he was immensely relieved to give it up (not to mention the rash of hijackings he had to worry about at the time as well).
The rash of hijackings was in the 60s. I once looked at a Wikipedia list of hijackings. There were like 5 in one year alone! They only stopped after 9/11.
@@ferretyluv 5 hijackings in a year is a "rash"? There were 41.9 million passenger flights over 45,091 airline routes in 2017. That's 0.0000001% chance of a hijacking.
@@sammiller6631 I said “pre-9/11.”There were 5 hijackings in 1961 alone. Then there were 6 in 1969. There were 12 in 1970, and 11 in 1971 (3 in one month and 2 in the same week!), and the golden age was 1972 when there were *17*! It got the point where all pilots were trained to have a flight plan for Cuba in case of hijacking. People saw hijackings like we see school shootings now, as the butt of dark jokes. This is also why on 9/11 the protocol was to let the hijackers do what they want. People thought they were flying to Cuba. Post-9/11, in the west, there were very few successful hijackings. Every one I could find was all “attempted.” The successful ones were some crazy New Zealander lady and copilots.
@@sammiller6631I know numbers are hard, but in the 1960s, there were FAR fewer flights in the air than in 2017. Get back to us when you find 1960s numbers, mmmmkay?
As the chief of women’s medicine at my hospital I can honestly say rising to this point in my career was easier than learning how to find the right Walgreens in a city where we have 17.
I can't tell you how many times the patients call in looking for meds that were sent to the wrong one because someone clicked on the wrong option. One time our clinic sent the med 14 states over.
Hi there! I used to be a programmer for a major Electronic Medical Records company. Months of onboarding was spent on learning only the most common documentation workflows (and optional months more for any specialties you needed to work with). All of this, while dealing with the casual problems programers have: "It took me 2 hours to find that I forgot a semi-colon!" "Does this list start counting at 0 or at 1?" Except, with the knowledge that if we let one of these bugs slip through, it could cost someone their life. As for why the systems need to be so complex... well... make a simplier human. The argument I give is "Make a form to fill any kind of perscription such that it needs no extra notes." It quickly becomes overwhelming with the amount of variables to consider. I still use the shared "trauma" of using EMRs as a way to connect with Medical Staff, let them know they're seen, that I understand.
I helped build reports on a tool that used commas on the tool, but semicolons on the web version of it (or the reverse - it’s been over 10 years). You had to remember which one went on which version if you were trying to make a change, though it DID at least show up correctly on whichever other one you hadn’t made the change on afterward. I also ended up taking the 278 page manual the company handed out on how to use the ticketing software we were building reports from, distill it down to about 12 pages, mostly screenshots, and give it to people who could then magically use the software. Beware of how you name that document, because “Mary2again’s Quick and Dirty How-to” looks bad spread across a worldwide company. Oops.
Worked at a clinic where we used 4, count em, 4 different EMRs at the same time. It got so complex that once I retired and Obamacare happened I had to step in and help my critical care pulmo with his new EMR. A patient working on the doctor's EMR....
You would think the glorious free market healthcare industry would have just provided the most optimum solution to medical records... I swear half of these companies snuck into logistics through lobbying the hospital or or made as a conflict of interest venture.
Working in EPIC as an NP, this brings back flash backs to our transition about 3 years ago. Epic is a human factors nightmare of errors in potentia. We need to see how Neurology would react to Epic.
Nurse here. I find that Epic is great for finding information. But it’s a bear for entering info! The amount of time I spend scrolling, clicking, and typing ruins my shift! However chart audits, or other retrospective searches are much easier than with our previous system, and when I reach way back in time to paper charts I remember what a nightmare it was to find anything but lab results and anesthesia records. And it was still a big job to follow nurse’s flowsheets just because of the minutiae. We used a double sided page that unfolded to the size of 9 standard pages with fronts and backs! I too know of docs who retired or handed off all their inpatient cases to Hospitalists because of Epic! I shed tears during the Epic rollout myself, because a supervisor asked me if she could help. I told her no! I didn’t have time for her to help, and just kept paper notes on the issue at hand until my shift was nearly over!
Medical student whose dad is a doctor. Yeah, the 90s and 00s was a different time and I recall my dad having tons of charts, it was a pain to find anything. I recall all the older docs just hating the use of EMRs back in the day when they first rolled out. During my training, I've used a crazy amount of EMRs. The best one by leaps and bounds was Epic. Easy to find info and with smart phrases not difficult to enter info. If I had to use MedTech again, I would just quit medicine altogether. LMAO
I remember being "trained" as a "superuser" and having to show the instructor how to get the speakers and projector working. Then had to show the instructor how to use EPIC... it was at that moment I saw a future in which thousands of IT professionals would be crying out in pain.
I don't know. I work at two hospitals and the happiest day of my life was when the other one switched to Epic. Of course, I already knew Epic well from the other hospital. At one point when I was doing locum work, I had to know four separate EMR systems. And the two hospitals I work at that are physically across the street from each other couldn't view each other's records because they were on different systems. That was true hell! So now having everyone on the same system and actually being able to communicate across hospitals is a glimpse of Heaven to me 😊
I’m the only dental assistant in my office and I’m also the youngest person in my office. We are getting new dental software and computers…. I also used to work in IT. Send a prayer to the IT gods for me
As a social sciences' student at university (Germany) I earned some money through testing user platforms / surfaces. My boyfriend 's company had written a new program and I was the "DAU" (dümmster anzunehmender User = assumably most stupid user), which was, in fact, true 😂. So I went through the program and marked anything that was not clear to me or misleading. The IT specialists then reprogrammed a lot of things and the feedback was, that there waa a gigantic gap between what IT specialists think is "totally clear" and an ingenous user's experience like mine who struggled with "apparently" easy applications or commands. Your skit is on point, Dr. G 🥰😂
In EMS we went from a 10 to 15 minute written report to an electronic one that takes 45 minutes to an hour (bragging rights if you get one done in 30), so I feel the pain!
naw; i still run my home servers w/ proxmox and ubuntu and vm’s galore; can code a bit, and i get to work and can’t figure out what the emr programmers were smoking.
Learned Fortran back in school and then hobby learned C and Linux. Put out grand rounds online back in the 90's with global reach. Didn't matter. Epic is a great way to name the mess of a medical record left behind once it's installed.
I started my PT training two years into the pandemic, and all of our theory classes were online. The ortho / traumatology lecturers still hadn't learnt how to use Zoom, and the first 15 minutes of each class was just them trying to figure out how to get it working. I actually felt pretty resentful that they expected us to learn about so many different kinds of injuries surgeries in six months, when they hadn't learned to use a basic computer program in two years 😅
1:11 I remember every time I learned a new smart phrase, it felt like I’d discovered a new cheat code. And when my coworkers saw me use them they’d beg for me to teach them too - I felt like the coolest kid I never was growing up. At 18. Amongst a bunch of 50-75 year old women 😂😂😂😂
Working at a University and trying to get tenured faculty to learn any computer system is the same thing!! “What do you mean I can’t just tell you to do it anymore?” Every Professors nightmare brings a wee grin to my admin heart ;)
I'm a technical writer and I have worked in IT as a writer/trainer for about 20 years and this made my toes curl...even the ones on my right foot that don't really move because of my cerebral palsy. It seems like EPIC has a huge user interface design problem and needs to be completely redone so it's easier to use. Also, doc, you nailed Techbrp's look!
Clinical tech everywhere has huge user interface issues. Rapid scaling and Frankenstein architecture doesn't make it easy. Due to the complexity of the users' interaction with machine, it's not a simple design either. Hospitals are also cash cows; they often don't have a choice but to accept the vendors limitations.
@@AuranHarpy Spot on with the frankensteining. One of our major vendors software has bits that clearly haven't been touched since the 80s because the company keeps getting bought out and flushing staff every time they do. So now they're in a situation where none of their support staff knows how anything works because they fired all of the people who did. I routinely have to argue with their engineers because they all act like the first time they saw a computer was yesterday, or have been doing the same thing for 20 years without bothering to revise SOP. It's a gigantic mess.
Please, no....I finally mostly sort of figured it out. So now you're going to completely redo it and I'm back at square one. I see you subscribe to the same "keep 'em guessing" school of IT that my hospital does 😞
Epic’s interface is inconsistent and irrational, and the workflows were designed by madmen. It looks and functions like it was written for the Amiga 2000 in the late 1980s. It’s also the most intuitive EMR that exists, which tells you how bad things are.
I've had to teach at least six new coworkers our discipline-specific EMR. Invariably, anyone over 55 double clicked every. single. time. And it never happened with anyone younger. I die a little inside anytime I hear a double click.
@@valdenay7264 hi, I'm an early millennial and I was taught to double click. Is this, like for real, no longer a thing? And if so how/why am I only finding out now? I'm confused... Help from anyone would be much appreciated!
@@sketchyAnalogies Double clicking is still a thing occasionally. Mostly on a computer's own OS. I can't think of a single time you need to double click when you're on a website.
I worked in IT for 3 years. I worked for a company that sold groceries and had a clinic inside the stores. The NPs were very smart knowing the human body. But the moment you tried talking about how to fix a printer or how to remember their password that was another issue. Oh and several times when we would connect to their computers they would be away and they would leave laptops signed in and signed in charts system.
Hilariously true as a former 'techbro'. When we had new users we set up an all fancy test environment where we'd invite them to try anything and ask us about anything and bring up any issues. (And we actually wanted to help and we were available.) But of course, none of that happened, because users don't really have time for that because they have actual jobs to do, so everyone who was asked to look at it just said it was fine, and then you go live and BOOM, the world explodes. (Talking to the users after the initial moment of agony was actually fun though, especially because we were small enough to be able to change things that would help the users. But it takes time, and change is hard, and having some system change forced on that interferes with the things you actually need to do will always be a frustrating experience.)
If anyone is in the Madison, WI area I highly recommend going to the EPIC headquarters. One of the craziest offices ever, different buildings have themes like Star Wars, Harry Potter, Alice in Wonderland, Dinosaurs and the Wild West. They have self guided tours open to the public where you just walk around looking at all the cool stuff.
Probably the EPIC headquarters are like that to soothe & distract any angry medical staff coming at them! Hard to strangle a programmer in a baby Yoda office....
I've been there for certification. We come from our shabby hospitals to the Richie rich epic campus and see where the hospitals millions of dollars are spent on.
I used to develop the Epic software. My wife still does. (Not in IT at a hospital -- literally writing the code for the application at Epic HQ.) Even we know how confusing it is. The sad part is that we poured countless hours into improving usability (without sacrificing important functionality) and it's still confusing. It's actually more impactful to invest in user training than into more development, but we all know how little anyone wants to spend even more time in Epic than they already have to.
I gave up trying. Out system some programming error where whenever a tonsillectomy was scheduled the H and P auto-populated with a "bleeding diathesis." Not accurate, but EPICs "simplification" required editing each time or it produced an error in the medical record. I became a PITA EPIC user - Many written reports, many calls, and it was never fixed. No one could find the programming error (or didn't care enough to try/always had more pressing things - like how to improve the billing modules). I'm very glad to have retired.
@@TheRealJBMcMunnAnd yet it's a necessary part of every job in patient care. Also, it doesn't "pull you away," you don't abandon your patients for training. Classes are held separately for that.
@LulaMae21 "Dammit, we need some computer crapware to add to our workload and distract us from the patient", said no doctor, ever. EMR is NOT necessary for providing care. It's for billing. And they used to train us while we were working. The docs refused to get trained without being paid for their time and the hospital was too cheap to pay us.
@HiYesThisIsJake I'm not sure if you realize how profound your comment is. So many issues in the US health care system can be whittled down to the inherent difficulty involved with herding cats.
As someone who manage releasing new tools and assisting users, this is the most relatable vid I'd seen from doc. At one time I had several calls just to show them how to operate it. It was during pandemic, so vid calls only. We had a website for a step by step guidelines and when I recommended it, she ask me "do I need to read that?" I mean why did we created it? To waste several hours writing and designing that website. We're only 2 persons to 1000 users. Like please understand, we can't assist you all.😂😭😂😭😂😭
I worked at a hospital when it changed over to epic. This skit is, if anything, understating the chaos. It's been a couple of years now and people still have problems with epic.
I managed to teach my boss to stop double-clicking when I stared over their shoulder. But of course, the one time they chose not to double-click was on the only thing in CERNER that required a double click.
and someone on the IT team..this is too close to home. Just wait till they have to fix their Charges, but can't override the price due to a discrepancy in the fee schedule.
Every time I have to deal with new physicians, I have to deal with the absolute struggle of them: 1) Not knowing how to order things and expecting me to order things and they just cosign (Spoiler: I can't) 2) Forgetting to sign their orders so they just end up stuck in pending 3) Doctors not reconciling their orders. Resulting in Q4 Fingersticks, Q6 Fingersticks, ACHS Fingersticks, and no insulin orders. PS: Just got macros implemented in my organization's epic, and I thought it'd be super helpful in cutting down my time documenting the near same assessment...But it doesn't really let us macro anything aside from WDL. And with the population I work with, almost nothing is WDL. Ouch...
"They have to be reminded??" I've friends and family in the medical community.... Doc G once again you deliver awesome funny-cuz-yup. Your playful satire is always a delight that gives me a smile each time you release one. Also, caught your explanation on who you don't and what you don't aim at in your comedy and it was so respectful and respectable.
I am spoiled in that I got to use Epic for many years prior to becoming a provider. Struggle-bus though the transition may be, it is so, so, much better than the MS DOS systems still being used in way too many facilities in the US. That, and the lack of standardization makes so many medical and drug diversion issues worse. I started out in a clerical role, and the managers reminding staff that doctors aren't allowed to hit them is a hilarious reminder of those days. xD
As a Tech Bro - unfortunately this doesn't just apply to healthcare settings😫For us it's ANYWHERE users interact with technology; work, home, relatives, friends, (soon to be ex-friends 😬) It's a PEBKAC issue - Problem Exists Between Keyboard And Chair 😄 Keep up the great work, Doc Glauc - Tech Bros are more likely than others to need your services 🤓
I genuinely had a user use a disc drive as a coffee coaster. Have you? The user KNEW it was a disc drive. They just thought that if enough people mistreated the disc drives that it would speed up the company phase out of CDs
🤣😭 All the feelings 😄The doctors--and I--need a support group now. As a patient with way too many appointments, that Epic screen is both comforting and disturbing. But doctors learning Epic is pretty much how teachers feel when given new online programs once or twice a year because the "admin bros" are sold on it being the latest and greatest way to teach [subject]. 🙄
One of our regions of the country i live in switched to Epic while I was in my final year as a medical student. The senior doctors were not happy about it and the people responsible for the switch conveniently stepped down from their post before the final rollout. The resonance after the switch was not good and quite a few senior doctors chose to retire from the regions hospitals. I myself got only to know Epic as a junior doctor. When i switched regions, I experienced how simple the other system is, which is used in the other parts of the country. I would like to avoid Epic in the Future, if i can.
@@gregd018 Right?! I've used Epic and a DOS based version of Meditech. And while I really appreciated that I never had to use a mouse with a DOS based system, I wouldn't call it superior. And while learning something new was hard, Epic was much more useful than that version of Meditech.
Let’s face it, Cerner stinks too. Our hospital had us (RNs) writing focus notes end of shift on every patient so the oncoming shift could figure out what went on.
OMG !! It's so true and relatable !! Typing on the EPIC (known as HMS in my hospital) is such a pain -- and the end-result is so stereotypical and boring..... On a handwritten note, you can underline important orders, use a red pen for "DO NOTs" , circle an abnormal ALT/AST value amongst a sea of other normal LFT parameters, draw a pain diagram, draw a flowchart to describe your care plan, staple an ASIA scale /BASDAI / MMS to the note-sheet >>>> all of these are simply missing in the electronic format.
@@namastehealthcare7163 While true, that only matters if your paper is actually accessible. If they end up at another hospital, only way they are going to see all that info is if it's in a system.
@@namastehealthcare7163Depends on what you're used to. Most younger staff will have rarely or never used paper charts. I haven't, and I've been a nurse almost a decade.
As we were tooling up to make the transition to Epic we were told of the many advantages of the system; ease of documentation, ease of exchange of information across platforms, ease of data accumulation and analytics.and finally, the most important advantage in the eyes of the administration - the financial benefits regarding billing and collection - not only did no one admit to the end user that this was going to take more time to chart and document but when confronted by the end users, that is the medical staff who were actually the foot soldiers in this cabal, the administration has refused to objectively demonstrate to the medical staff the fruition of OUR efforts. Talk about a campaign of disinformation. Has the EMR really improved patient care as they claim? While the "suits" go home from their 9-5 jobs, we, the medical staff remain in the trenches after our long days of patient care fighting with the EMR. I have yet to be convinced that patient care has improved as a result of the EMR - no one from our administration has come forth with any compelling evidence - just sayin' Gosh, do I sound bitter?
So stinkin true! Nurse here. When our hospital switched, I took 24 HOURS of Epic training classes (I’m a float pediatric nurse-they made me take the training for every unit I go to). I spend more time documenting than actually taking care of my patients. The whole system is ridiculous.
Logging into the Secure Data Server at the University is the hardest thing I have done as a PhD student. And the hardest thing my Professor Supervisor has had to do while supervising me. We called so many techbros.
As someone who teaches medical staff new software I can relate. It's also amazing how there's some incredibly smart Doctors out there who have no idea how to use a computer.
I remember our first time sending a record to another hospital. The lady, on the other end of the phone, told us not to ever send her another record. 😂😂😂 Epic is truly epic for bringing out the worst emotions ever. ...my favorite part was having to cover for every department because it was taking them to long to get the records up and running or transfer over. ...oh and how only one person is allowed to be in a patient record at a time. So, imagine me having to tell my boss of medical records that the doctor of the patient called to tell her to get out of the record because she needs to finish up with that patient's appointment. 😂😂😂😂 Epic
Locking of records is a… very long discussion, but at the end of the day it is because of the horrors of desync. A doc could try to document information about a patient, hit save, and someone could have written down another piece of information in the same field. What value should be stored? Locking records is a band-aid fix to that problem, that can also cause issues itself. But no-one can engineer a solution that is better so far.
I had to use to the new version of our EMR in clinic yesterday for the first time, having used a simplified overlay on the previous system, and it’s a good thing I had plenty of time with that patient. It took me over an hour to get the charting done. I miss Epic, it was so much better.
Electronic medical record. Think your utility company's website but instead of your utility bills you get important information about how fucked your patients are
My least favorite Epic start memory was building some notes and adding a smart link to bring in labs. An actual Computer Engineer working for Epic looked at it and had never seen that smart link. Turns out that there are something like 5000. Basically Epic has customized the names for all the customers and never cleaned up the database. It's like late phase DOS or the OG Debian Linux downloads. A mess of a system.
as a fairly techie nurse I get all the questions that the MDs don't want to call IT about... "Nothing here requires double clicking" speaks to my very soul...
I’m a radiologist and I had the honour of being on evening call during PowerScribe (dictation system) update…had to wait 3 hour until 2 am to resolve my issue. Soon, we will be getting a new PACs…yay…
It's all true. That's EPIC. The entry of chemotherapy for inpatient leukemia is so cumbersome, so difficult, so prone to making errors that you would miss that my partners and I would simply give hand-written orders to the pharmacist and tell them "you enter these into EPIC". It's that bad. But the worse thing about EPIC is that the outpatient physicians are unable to send (fax or mail) their office notes to other physicians involved in the patient care. So, as a medical oncologist, I NEVER received consult notes from other consultants who used EPIC and certainly nothing from the primary care physicians. We would use Loma LInda for some tertiary consultations but we would NEVER get a reply. Never a consultation note. Loma LInda uses EPIC. (In contrast, the EHR that we use makes it very easy to fax notes to other physicians. Faxed at the same time you complete your note). Let me tell you,... not getting notes from other consultants makes patient care much more difficult and prone to error. This, in my opinion, is where EPIC fails miserably.
That's not Epic - that's the decisions your leadership made. Epic can absolutely send notes and other information in between instances of Epic. They need to go live with Care Everywhere. There are also automatic ways to send letters to other members of the care team as soon as your encounter is done. Epic has some of the best capabilities in the EMR space - but it is all in how your leadership decided to implement it and how proactive your physician champion and informaticists are in pushing for additional functionality.
But it doesn't happen. The hospital that I work(ed) at tells me that it is illegal to send notes. EPIC people says it's fine, but EPIC does nothing to get the hospital to agree to have their physicians send notes. Physicians at Loma Linda, the closest tertiary hospital NEVER sends notes. If it's so easy to send notes with EPIC then why does no one do it? I've begged them for years to send notes and they won't. The City of Hope medical center has EPIC and on only very rare occasions to they send notes. It's the same for another half dozen medical centers that we occasionally send patients to. @@suzannepowellcole2942
@@davidyoung6331 I've never heard that it is illegal. Could be a state-specific regulation or how your hospital system has interpreted a regulation. Epic can't strong-arm a hospital into workflow decisions since ultimately the hospital is the one liable for how they use their EMR. Epic's Care Everywhere can make it almost seemless to see other Epic hospitals' notes, imaging results, genomic testing, and to pass referrals along.
@davidyoung6331 Like they said, it's because hospital leadership doesn't want to bother setting up CareEverywhere there. Epic will promote things to their clients, but they don't force build on their clients. So if the C-suite doesn't want a particular Epic module, and the doctors can't talk them into it, then, your hospital isn't getting that module.
When we went to Epic, the surgeons were all told they had to be signed off on their test modules, or they would NOT be allowed into the OR to start cases. One of them breezed in, initialed the surgical site on his patient, and told them to roll in the patient. We said we couldn't because he wasn't signed off on Epic. Entertaining? You bet. His tantrum was EPIC, especially when the OR Charge "put on the hat" and told him, "No sign-off, no OR" He screamed, threatened, said he'd get to it when he was done operating. Lol! He flew off like a bat out of hell...and went and finished the module! I had EPIC respect for the OR charge that day, and even admin (a rare occurrence) because they backed her up.
If it makes anyone feel any better, most companies dealing in non medical fields have easier, simpler, systems that are supposed to make everything faster and more efficient. And they do…for about a minute. Until some higher up decides he saw something cool on tv or read some article about a competitor using a new system and turns around and pays insane money to buy systems they don’t bother to actually learn what their function is, or how it’s supposed to work. And the actual, day to day, backbone of the company, we can’t function if they don’t work, non broken systems, are routinely fixed until they are broken beyond use and a backup system have to be reinstalled. Man I wish I could retire.
My employment term at the hospital ended the day before the switch to a new system. I am so happy about that. I had some relatives in the hospital as patients on that day, and they witnessed such chaos that at one point the managers gave ice cream sandwiches to staff to make them feel better.
Wonder what the stats show between patients coming to harm due to bad handwriting, bad use of abbreviations/Acronyms/initialisms or just gobbledygook in patient notes versus a hospital that still uses paper vs use of systems like EPIC? Before I was made redundant from the NHS I was setting up a team to combat patient harm due to poorly written records - there are 1,000s of needless deaths or patient injury each year due to this.
Just going by how many fellow women have been asked about pregnancy when their chart says in fat latter they had hysterectomy or are other infertile, tells me that writing isn't always the problem 😅
My son had his second PET scan the DAY the hospital got EPIC. Someone forgot to put in the order, so we waited for about 4 extra hours. Yay. He was 4, and had to be NPO for the scans.
The cut to the Epic Login page made me laugh so hard. I actually worked at Epic, albeit in the (then) brand new Epic Hosting subsidiary. Our biggest customer was Mayo Clinic. They had 20,000 users all running on Cisco UCS blades at a datacenter at the Verona Headquarters.
As a former "superuser", this is completely accurate. Doctors did everything they could to not have to learn the system. The predominant fixes many came up with were either to hire an NP or PA to do it all for them, or to drop off of rounds & letting the residents handle it, or just chucking it in & retiring. Training the nurses wasn't any better. Lost some of those to retirement too. The errors amongst all staff were extraordinary. We "superusers" in our frustration eventually ended up calling the worst offenders "stupidusers" behind their backs. Ah, those were the days...from hell.
Honestly, they shouldn't be learning to use this system. They should be focused on their jobs of actually providing care. Everything else should be automatic catered to their needs.
I can remember this coming in a hospital and it wasn't fun. My last nursing job got one and it had spelling mistakes in it. It had glichs in and the IT person hid as he was getting so many calls from the nurses.
I'm not in the medical field but this is how I feel whenever I have to deal with changing technology. Even a new printer gave me panic attacks because I could print PDFs but not Word docs.
