I wonder how much of this comes down to Professional pride.  It
surprises me the rubbish that people will send out; the excuse is often
that there is "not enough time" or "I didn't know how to change it."

If your carpenter couldn't sharpen his tools, or couldn't saw in a
straight line, you would question his ability.  Computerised EHR is the
professional tool of the doctor.

It all smacks of lazziness and poor professionalism to me.

Michael

Greg Twyford wrote:
> Cedric Meyerowitz wrote:
> 
>> You wtote: Drug interaction databases need to be not dangerous (example a
>> patient being allergic to Bactrim but the doctor can happily prescribe
>> Trimethoprim)
>>
>> The problem is not with the software developer but with the Doctor
>> using the
>> software.  When there was a big uptake of IT by GP's a few years ago,
>> when
>> HIC offered all this money for IT uptake, there were lots of articles
>> published about GP's printing scrripts with default settings of the
>> program
>> - ie. Take 1-2 tablets when eyedrops were prescribed etc.  I still
>> regularly
>> see scripts generated elsewhere, where the Doctor hasn't bothered to
>> set up
>> the margins.   I still regularly get new patients and there health
>> summary
>> contains the same diagnoses twice, the same drugs are prescibed twice
>> (example Losec 1 nocte, Probitor 1 nocte) - only because the Doctors
>> don't
>> know how to use there software, or they can't be bothered. 
>> When it comes to allergies:  Bactrim allergy implies allergy to Bactrim.
>> That implies save to give Trimethoprim.  If the allergy was to
>> Trimethoprim,
>> the Doctor should enter the allergy as Trimethoprim.  We all have
>> patients
>> that are sensitive to Valium, but they can safely take Ducene.  Thus
>> there
>> is a difference in how one enters a allergy.  I still have female
>> patients
>> that claim Triphasil didn't agree with them, but Triquilar is 100% okay -
>> yet is exactly the same drug.  Amoxil allergy again does not imply a
>> Penicillin allergy. 
>>
>> Cedric  
> 
> 
> Cedric,
> 
> My take on this problem is that the funding to Divisions for training
> their members cut out way too soon, and the powers that be thought that
> if a GP had a PC on their desk, they could do anything and everything
> the powers imagined with it. Some Divisions are still running training
> programs, and yes what you describe is still, unfortunately, not uncommon.
> 
> Another variant is having everything ever prescribed in the current
> medication list because everything is selected as 'regular'. This annoys
> specialists, of course, who discover that the patient isn't on most of
> the stuff in the referral letter. Only a few months ago one GP asked why
> some of the listed medications for a particular patient were in red.
> 
> I think what you are saying is that we need to certify the doctor's
> capacity for using their clinical software as well as the software
> itself. Mr Abbott quoted a study late last year that obviously made him
> aware that everything isn't rosy in this particular garden, but to date
> there's been no action other than some changes in the PIP incentives,
> which were long overdue anyway.
> 
> Enough GPs I know have developed good skills, are conscientious, and
> make their software work for them and their patients, for me to feel
> that efforts to continue offering training are worthwhile.
> 
> Greg
> 
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