- “Niche” Computer Systems
- Meaningful Use
- “Wrong Patient”
- Cognitive Friction
- Dialog-Box Rooms
- What’s in a word?
- Cost Disease
- Model T
- Signal-to-Noise Ratio
- Anti-Data Pixels
- Fitts’s Law
- Bad Apple
A point-and-click electronic medical record (EMR) can be very fast, at least for simple, uncomplicated cases. However, some point-and-click EMRs try to convert the information from clicked checkboxes into English. The results, just like the corrections applied by a word processor spellchecker, or the misrecognition when you’re using speech-to-text on your phone, can be amusing. My recent favorite text was when I was at a Chinese restaurant after work and my wife, who was on her way home from something, texted me to bring home some tungsten fried rice. (It was supposed to be young chow = combination fried rice.) But my all-time favorite is what I first heard of as Ode to a Spellchecker.
Candidate for a Pullet Surprise
by Mark Eckman and Jerrold H. Zar
I have a spelling checker,
It came with my PC.
It plane lee marks four my revue
Miss steaks aye can knot sea.
I recently heard about a physician who was known for his scatological speech, who was dictating a note and set the phone down for a minute to verbally castigate a nurse. The resultant string of curse-words got picked up verbatim by the speech recognition software, and the transcriptionist/correctionist decided to leave all of it in the dictation. I understand she got a written reprimand from her supervisor and a big present from her co-workers.
But perhaps a medical record is not the best place for humor. So those who try to formulate English sentences out of clicks on a page of checkboxes should take care. Perhaps they should have a high-school English teacher grade them on their programming.
A point-and-click EMR that I use recently added some checkboxes for screening related to falls in the elderly, and travel outside the USA. Given the seriousness of recurrent falls in the elderly, and concerns over the Ebola and Zika viruses, this sounds laudable. However, by adding checkboxes for these things to the Chief Complaint section of the EMR, some interesting sentences result. Here are two Chief Complaints entered by the nursing staff from day before yesterday, as rendered into English sentence by the EMR Docutap, with initials changed to protect the innocent triage person. I should put in the initials of whoever set this up, but I don’t know who it was.
Chief Complaint: Patient comes in today for a Congestion and *2or> Falls Past Yr – NO. x3d ab,ma (SOURCE: Patient)
Chief Complaint: Patient comes in today for a Cough, *2or> Falls Past Yr – NO and *Travel Outside US – NO. productive w yellow mucous. xx 1 week cant sleep due to cough. cd, ma (SOURCE: Patient)
[Insert 4/9/16: here’s an even better one: Chief Complaint: Patient comes in today for a Dysuria, *2or> Falls Past Yr – NO, *Fall Injury 1 Year – NO and *T,ravel Outside US- NO. Frequency x 2 days. za,rn (SOURCE: Patient)]
Any high school English teachers out there?