FEEMRS: Fancy Expensive Electronic Medical Records System

I was at a locums assignment yesterday using FEEMRS. (You know, ‘Fancy Expensive Electronic Medical Records System?) It was all kinds of busy, with wait times of many hours. And as I slogged along, relearning FEEMRS after a few weeks away, I realized that it takes about one hour of looking at that screen for me to become exhausted.

It’s just too ‘busy.’ Every bit of the screen seems filled with some data, some field, some time-stamp. Oddly, I struggle to find the triage note, the home medications, the history. I struggle to find whatever orders I have entered and to see if they have been completed. I throw my hands up trying to discontinue orders and I nearly weep when it’s time to discharge a patient, a process which takes far too long with various orders, time stamps, discharge instructions, medicine reconciliations, printer selections and all the rest. Honestly, it’s far easier to admit someone to the ICU than to discharge them. At least in terms of computer time.

That’s the thing about FEEMRS. The ‘flow’ is all off. Oh, it’s data rich. But it’s mentally exhausting. Too many clicks, too little useful data, not nearly enough ‘white space.’

Furthermore, there are the orders to sign and the charts to sign. And after you’ve signed them, there’s another place to sign. And if the nurse so much as helps them to the door, and enters that fact with appropriate time-stamp, ‘0300, touched patient on elbow at door,’ well it’s going to need another physician signature to validate the elbow touching event and document that it was necessary, approved and billable.

Docs using FEEMRS across the country are daily beset by hundreds of orders that require signatures the next day; things we didn’t even know were orders. ‘Placed bandaid.’ ‘Paged nursing supervisor for admission.’

A friend of mine was asked to sign nursing orders for psychiatric meds (Psychiatric Meds!!!), placed by nurses for hold patients three days after he went off shift. He wisely refused but was told ‘its OK, everybody does it’

By contrast, this year and last, I worked at TMH (Tiny Memorial Hospital and its several campuses) where I (gasp!) used paper charts or dictated to a human transcriptionist. My patient’s meds were either in front of me or one flip of paper away. My discharge instructions were a check mark away, or three clicks on a different program. And often, for orders, I check a box and handed it to a secretary to enter into the system. In some instances, my prescriptions were written by hand (not perfect) and could be ‘deleted’ or ‘reconciled’ with a simple tear of the paper.

I notice, now, that when I go back to my hotel room after working with FEEMRS, I sleep poorly. No wonder. I’m clicking and looking, scanning screens and logging on and off until 2 am. I tell my kids to stop looking at screens before bed or they won’t sleep well. I keep it up till the wee hours.

FEEMRS is quietly, slowly, electronically killing all of us and making us less concerned with patients than we are with fields, files, clicks and saves.

Something has got to be done…

I just do n’t know what.

3 thoughts on “FEEMRS: Fancy Expensive Electronic Medical Records System

  1. Hi Edwin , at our local doctors office run by GHS now the docs are getting hit with not only a crappy EMR but a $100 dollar fine per a chart not closed in ten days. The solution? Cut back on patients seen a day so you can have time to finish charts. Glad to see the promise of EMR is strangling the doctors and patients both at the same time now.

  2. Humor is a prerequisite for working in the ER. (Back in the day we called the ED the ER). Your posts take me back many, many years ago to my own ER that has changed so much over the years that I would not even recognize it if I woke up in the middle of it. I’d have to ask where I was. I think it’s a safe bet that the new EHRs would have added yet another trauma to the already unfolding traumas that were brought to us every day. It’s always something…

  3. Just found your blog. You’re hitting the nail on the head. I’ve been working ER for over 25 years (though I’m not EM “boarded”, so I guess I’m not really an emergency physician ) and your comments really strike home. Looking forward to reading more and maybe commenting on occasion.

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