WTF So I just dick'd my butt

wetwille

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MOAR WORK GRIPEZ: ok so sometimes, when people done fuct up, you have to make corrections in the chart. once a test has been given a result status of "Final," nobody at my clinic can "discontinue" the order (in this context, it's like deleting or cancelling it, but records are still retained). I have soent the better part of TWO YEARS trying to figure out how to get shit like that corrected. Every workflow I follow, that person says "ok, yeah I can fix it this time, but you're supposed to submit it [this other way]" except next time when I do that, I get the same but with a different way. sometimes it's a way I've tried previously. sometimes they tell me someone here at my clinic can do it (they cannot).

dude I am super good at following directions, and I am a people pleaser to a fault IRL, so it is stressing me THE FUCK OUT that I'm getting treated like a big dumb dingus who is annoying these people with my big dumb doing-it-wrong-ness.

and I have fucking SO MANY of these requests to make because of the previously whined-about person who fucked up all the shit in my absence. and no idea of where to actually send the requests.

I am just going to start shrieking and I might possibly never stop, I haven't yet decided.
In 35 years of looking at medical records, finding hundreds of obvious errors, I have NEVER, EVER been able to get a doctor to correct/change a notation in the records. And for some reason, psychologists are the absolute worst. HAve had a few who just totally flipped their shit, accused us of wanting them to falsify information. oooooooohhhh. No asshole, you said the person was in a work accident and I sent you the emergency report and the police report that shows it was a car accident.FFS.
I feel for you on this. You're right - with the way documents are duplicated and stored to multiple systems, it will be a cold day in hell that they let you or someone else start changing data.
 
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august

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In 35 years of looking at medical records, finding hundreds of obvious errors, I have NEVER, EVER been able to get a doctor to correct/change a notation in the records. And for some reason, psychologists are the absolute worst. HAve had a few who just totally flipped their shit, accused us of wanting them to falsify information. oooooooohhhh. No asshole, you said the person was in a work accident and I sent you the emergency report and the police report that shows it was a car accident.FFS.
I feel for you on this. You're right - with the way documents are duplicated and stored to multiple systems, it will be a cold day in hell that they let you or someone else start changing data.
for me, the doctors dont even really factor into it, and with it being EMR with a changelog, it would retain all originally (incorrectly) entered info. there's also things we CAN change, so like:
you place an order for, say, a CBC with differential. and then inside the order, there are components, which are discrete codes for each test component (WBCs, RBCs, etc) where you select a component, enter a value, a reference range, units, and a comment if appropriate. there's also boxes for narrative and for impression which apply to the whole order (not just an individual component). we can change ANY of those things inside the order, including just deleting everything inside it all out, but we here at my clinic cannot get rid of the actual order once it has been set as Final. not setting stuff to Final is not an option. and leaving wrong shit isn't an option because it still looks like the thing was done, even if it wasn't, unless you get to digging around.
 
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wetwille

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for me, the doctors dont even really factor into it, and with it being EMR with a changelog, it would retain all originally (incorrectly) entered info. there's also things we CAN change, so like:
you place an order for, say, a CBC with differential. and then inside the order, there are components, which are discrete codes for each test component (WBCs, RBCs, etc) where you select a component, enter a value, a reference range, units, and a comment if appropriate. there's also boxes for narrative and for impression which apply to the whole order (not just an individual component). we can change ANY of those things inside the order, including just deleting everything inside it all out, but we here at my clinic cannot get rid of the actual order once it has been set as Final. not setting stuff to Final is not an option. and leaving wrong shit isn't an option because it still looks like the thing was done, even if it wasn't, unless you get to digging around.
Gotchya. So the guy who's gone finalized all the shit and it's wrong, yet you can't re-enter the order because the system already logs it as done? That sounds pretty fucking aggravating.
 

august

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Gotchya. So the guy who's gone finalized all the shit and it's wrong, yet you can't re-enter the order because the system already logs it as done? That sounds pretty fucking aggravating.
YUP.
and finalizing it makes sense in the workflow, it's a necessary step, but if it's been done wrong it's a huge pain to change and apparently none of the several different ways I've been told to submit it for correction is right.
 

august

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in Epic, there are features that pull completed things into other places, like there's a health maintenance feature that shows all sorts of health topics someone might need (mammos, colonoscopies, etc), when it was last done and when it's due, etc. and it won't show as done there (and therefore not due) or calculate the next due date if it isn't set to Final.
but that also means that if someone did not actually have the testing done, I can't get rid of it (e.g. they actually had a CT colonography, aka "virtual colonoscopy" done, but it was entered as a regular/"optical" colonoscopy)
 

wetwille

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in Epic, there are features that pull completed things into other places, like there's a health maintenance feature that shows all sorts of health topics someone might need (mammos, colonoscopies, etc), when it was last done and when it's due, etc. and it won't show as done there (and therefore not due) or calculate the next due date if it isn't set to Final.
but that also means that if someone did not actually have the testing done, I can't get rid of it (e.g. they actually had a CT colonography, aka "virtual colonoscopy" done, but it was entered as a regular/"optical" colonoscopy)
I feel a little bad for trash talking the doctors & their staff - their hands may have been more tied than i thought. But my issue has usually been in text notes, operative reports, MRI reports,etc. Some of those, even on the modern systems, could certainly have a corrective addendum made. Usually they tell us it's $150, since that is what they charge for a narrative report. Even if only 1 sentence.
 

august

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I feel a little bad for trash talking the doctors & their staff - their hands may have been more tied than i thought. But my issue has usually been in text notes, operative reports, MRI reports,etc. Some of those, even on the modern systems, could certainly have a corrective addendum made. Usually they tell us it's $150, since that is what they charge for a narrative report. Even if only 1 sentence.
yeah I've had to contact other health systems to try to have them fix dumb shit mistakes before I abstract in, since I shouldn't take liberties/make assumptions and they get annoyed

like listen, fuckhead, I'm not the one who wrote that the person with the totally normal colon needs a repeat colonoscopy in 10 *days* instead of years, and I wouldn't have to make you fix it if you just did it right the first time, but sure, be mad at me.
 

Valve1138

I eat my own poo with a spoon
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in charge where?
my clinic?
the local hospital through whom we get our Epic?
the larger health system they're part of?
Epic?

there's so many layers to this fucking shit and I just need them to fucking give me the security/permissions to do this myself if they're not going to help me, but they won't (give me permissions OR help me) and I'm losing my fucking shiiiiiiiiit
can you schedule meetings?

Schedule one with anyone and everyone.

Let EVERYONE know they’re dummies.

Been there, done that, it gets results.
 

august

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can you schedule meetings?

Schedule one with anyone and everyone.

Let EVERYONE know they’re dummies.

Been there, done that, it gets results.
nope, I cannot

I did send back an email with my supervisor and the director of clinical ops cc'd

it was pretty crabby, but considering the first draft was just "ARE YOU FUCKING KIDDING ME" in size 72 font, I'd say it could have gone worse. I had not heard back at the time I left work.

you know that blinding, dizzying rage feeling where your BP spikes and you can't feel your fingertips? it was that kind of day. all day.
 

Valve1138

I eat my own poo with a spoon
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nope, I cannot

I did send back an email with my supervisor and the director of clinical ops cc'd

it was pretty crabby, but considering the first draft was just "ARE YOU FUCKING KIDDING ME" in size 72 font, I'd say it could have gone worse. I had not heard back at the time I left work.

you know that blinding, dizzying rage feeling where your BP spikes and you can't feel your fingertips? it was that kind of day. all day.

Time to poop on someones desk.
 

Domon

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nope, I cannot

I did send back an email with my supervisor and the director of clinical ops cc'd

it was pretty crabby, but considering the first draft was just "ARE YOU FUCKING KIDDING ME" in size 72 font, I'd say it could have gone worse. I had not heard back at the time I left work.

you know that blinding, dizzying rage feeling where your BP spikes and you can't feel your fingertips? it was that kind of day. all day.
you know you can solve this by not caring.