optimize the system for individual users — or at least a particular spe-
cialty — to take advantage of all the tools pertinent to that specific
specialty.
This is a case in which it's probably best not to have been an early
adopter, because the architectures of some EHR systems were built
years ago, using archaic computer languages. The vendors who made
them can provide updates to make the systems more robust and even
more intuitive.
"It will degrade the quality of our documentation." An electron-
ic patient record can occupy a lot of space, and some of the
information it may ask for may be irrelevant or relatively unimportant
to the surgeon. While that in and of itself is not a huge issue, there are
some critical pieces of information that can be difficult to access. In
most cases, this is an easy fix. Take a progress note, also known as
the SOAP note, which is short for subjective, objective, assessment
and plan. The subjective and objective could literally be 7 computer
screens long, so the simple act of reconfiguring the SOAP note to an
APSO note, so the assessment and plan are at the front of the EHR,
would save a lot of time. The subjective and objective are still there
for those who need them, but accessing the meat of the record — the
assessment and plan — becomes more straightforward for the MDs.
"It will be too difficult of an adjustment for our technology-
averse staff and docs." Physicians of my era — I'm 55 — may
not be as facile with computers, or technology in general, as junior
faculty or doctors just coming out of residency. In fact, some older
physicians have such a fear of doing things "a new way" that when
word comes that their facilities will be moving to EHRs, they acceler-
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