Are you one of the 54 percent of all Americans whose medical records are typed and stored on Epic?
If you don’t know, let me ask you this: does your doctor look at you when you are there for a visit, or is she (or if she’s lucky, a “fellow” or assistant) typing the whole time? That’s Epic.
It is, of course, a brilliant idea, and made its founder Judy Faulkner (a woman in tech, hooray) a multibillionaire. Unfortunately, I’ve had a lot more experience than I’d like with Epic lately, and most of it has been pretty awful, but as always, it’s not the fault of the software. The software, as far as I can tell, works rather seamlessly. Human beings are less seamless.
The good part is that while I’ve been treated by doctors affiliated with a number of different hospitals, they can access each other’s medical records. And at least in theory, when I go through my medications list for the thousandth time, the updates that I gave at Stanford on Friday should be in the records when they pop up at UCLA a week later. The problem is that while hospital labs are pretty good at posting test results, doctors who use private labs are not always so automatic. So when the woman at Stanford said to me, “I see you had blood-work in May,” I almost laughed and said, “How about June, July and August?”
As for me, the patient, what do I know? I don’t know who uploaded what. I don’t have access to Epic.
I have access to these rather insipid portals that each hospital has now created to make it impossible to communicate directly with your doctor, but to readily provide you with the test results you are not really waiting for or worried about — but when it comes to the stuff that really matters, this information is literally hidden from you, for doctors’ eyes only.
In the modern world, it’s pretty ridiculous: this idea that if you only let the doctor see the information, he will inform you in a kind and well-informed way, so you don’t go off half-cocked and have a double mastectomy.
As if anyone would. I can’t tell you how many of my friends were informed they had cancer via calls from curt assistants to their cell phones at awkward moments. At least you should be able to pick where you are and who you’re with when the bus hits. The various sites also make a big deal about how you can send an email through the portal to your doctor; what they don’t say, but my last doctor acknowledged, is that if you do that, she doesn’t get it. One of the nurses does, and they screen what she sees, so she only sees the ones they can’t answer. If you’re seeing as many as 30 patients a day, can you be blamed for not wanting to also hear from dozens of other patients?
But are you really “seeing” them? Epic produces a very nice after-appointment summary, which means that someone must be typing during that appointment. It really is pretty awful to be sitting there giving your medical history to someone who looks at the computer screen the whole time.
One of my old-fashioned doctors who doesn’t seem to use Epic said that the most important thing is to look at your patients. Not anymore. The only thing worse than the doctor looking at the screen the whole time is when he has an outside third-party contractor who is training in the room with you while he learns to use the system. Privacy anybody? But I suppose it’s better than the doctor who literally has no idea who I am, having spent 90 minutes with me last time, so the first half of the appointment is spent with her reading out loud everything she typed last time. She still doesn’t look at me.
The doctor who had her “fellow” do the typing — but taught both him and me during the process, explaining the choices she made — was by far the best. Ultimately, like everything, it’s how we use the tools that counts. This one is going to take some work.
The Dispatch Editorial Board is made up of publisher Peter Imes, columnist Slim Smith, managing editor Zack Plair and senior newsroom staff.