mountain-of-paperwork

When Paperwork Outweighs Patient Care

A recently hospitalized patient was met by a nurse with a computer monitor asking him to rate his pain on a scale of 1 to 10. This is what medical care has become in the age of electronic records. These records are notoriously inefficient, burdensome, and impersonal, yet charting is what medical personnel are evaluated on – not patient care.

Falling while in the hospital accounts for 11,000 deaths annually. Nurses can spend 10 minutes computing a patient’s fall risk or spend 10 minutes instructing them how to prevent falls (using call buttons, bedside commodes, etc). Computer records cannot prevent falls.

Home hospice reimbursement is denied if the electronic records are considered incomplete or flawed; even switching words around while not changing the intended meaning can be considered an error. Hospice admission takes two to four hours with endless numbers of data fields. A patient could die over a weekend before all information is collected.

Medicare Advantage health risk assessments are have the highest number of fields required. A physical exam, a complete health history, and diagnosis all need to be documented. Independent companies perform these evaluations, and they regularly “upcode”, or code a patient as having higher risk or a worse condition than in reality, so that the reimbursement from government will be higher.

Reimbursements should be tied to actual care given, not to just whatever the paperwork says. EHRs may look clean and clear on paper, but real patients are messy and unpredictable. Too much attention is given to paperwork, taking away real time with real people with real needs. Records should serve patients, focusing on accuracy, efficient treatments, and patient safety. Otherwise, electronic records will continue to damage patient care.

http://www.nytimes.com/2015/12/20/opinion/sunday/when-hospital-paperwork-crowds-out-hospital-care.html
Brown, Theresa. “When Hospital Paperwork Crowds Out Hospital Care.” Opinion. The New York Times, 19 Dec 2015. Web. 20 Dec 2015.

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