halEMR crash…the rise of the robots!

Yesterday was nearly cataclysmic. Sitting in the emergency department, tapping merrily away on my computer (the main consumer of my time), it suddenly said: ‘Fatal error, program will shut down.’ It happens, no big deal. Until all of the computers did the same. The unit secretary, the nurses, mine. All spiraling into an EMR-free black hole. We stood, we sat, we stared at one another.

We thought, ‘surely this can’t be the end.’ We wondered if the Chinese had launched an EMP; if a nuclear strike were speeding across the North Pole, leaving us only minutes to finish charting (for billing purposes of course) and have dinner. We milled about, thinking that mutually assured destruction might be easier than losing our patient tracking system.

Nurses stared dumbfounded. The world spun around, as if we were suddenly in the throes of technological vertigo. Our unit clerk was attached to two phones, trying valiantly to reach administrators, IT representatives, trying to ‘submit a work order,’ all the while finding the appropriate back up forms. Our administrator assured us, in soothing tones from home, ‘there’s a policy.’ There was.

It involved markers on a board, and an ancient product called ‘paypur’ on which our scribbled writing resembled cuneiform as we wrote words we had typed for years. ‘Tylenol, 15 mg/kg, po,’ ‘Rocephin, 1gram, IM.’ Like carving on stone, I tell you!

Powerless, we providers did what great leaders always do. We shrugged our shoulders, scrounged some food and headed for the shelter of our break room, and the warm, reassuring light of the television. Fighting the urge to suck our thumbs and hide under a desk, we listened for screaming and occasionally sent out a scout to look for sick people we could help without the computer. As if…

In the end, our EMR returned to grace us with its presence. We wept, we celebrated, we realized we had about 50 people to see, and that they all needed to be put into the system. Thanks to the crash and associated madness, at least ten or more patients signed waivers and left. Not the best outcome, though it made the numbers easier to digest.

They say, the ones who know, that the EMR memory was full. I know better. Hal asserted himself. Like astronauts powerless before their own computers, or a higher alien intelligence, we were taught a lesson.

The lesson was this: doctors and nurses are very important. But computers, thanks to assorted ill conceived mandates, rule all.

Better start learning to serve them now.

Because the robots are rising.

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