Today, I had a medical assistant covering for Autumn. Near the end of the day, she handed me one report from our emergency room and one from the competing healthcare system’s walk-in clinic.
A patient of mine had gone to the walk-in clinic for a toothache.
“I wonder why he went to the walk-in clinic for a toothache”, I said.
“I sent you a Task about it this morning”, she said.
That’s the workflow In Greenway’s Intergy. In eClinicalWorks, my other clinic’s EMR, “task” is called “Jellybean”, because the icon with the number of messages is one of several different color ovals on top of the computer screen. But it’s the same flawed idea: Pass messages to the clinician in the order they came in instead of according to urgency.
“Oh well”, I said. “I saw the task about a note for the landlord about a cat and the one about wanting a backdated referral and a hundred other non-urgent messages. Listen, I’m drowning in messages while I’m busy seeing patients. What Autumn does is put a stickie on my computer monitor about important or time sensitive messages. I would have sent in an antibiotic for that guy.”
“No problem, I can do that”, she answered.
I can think of lots of posts I have written about this before, but it needs to be said again:
There is a real danger that providers and patients will waste time doing the wrong thing at the wrong time when nobody directs and prioritizes the inflow of information.
Computer people, who sit at their screens all day, don’t acknowledge that providers are looking into patients eyes, ears and other orifices, listening to convoluted histories and solving clinical problems in the exam room most of our working day. The patients in the office are our priority unless someone with the appropriate triage savvy declares that a not-present patient’s issue should be prioritized.
Where else is the decision maker for a million-plus-dollar-revenue operation surrounded by helpers who dump everything on the boss’s desk without even trying to sort it?
I’m not the president, would not want to be – or even compared with one – but think about how ridiculous my workflow would be if applied to other arenas besides primary care (posted in 2015):
A Country Doctor Writes: 
I am retired, but I was the only doctor in my surgery who used to like Tasks. It was like a computer game, I reacted to them immediately in between patients, so never had more than 5 at the end of my clinic. When other doctors complained they stay for hours sorting the tasks, I thought maybe I et less of them. I counted it one day, but I didn’t I had 35 tasks that day. But all dealt with quickly. My partners used to tease me that I am an Android. Maybe I am. But just at work, at home, my papers are a mess…
I can’t switch gears like that, prefer not to even think about tasks with patients in the building.
I am an APRN. I recently assisted a practice by working from home and monitoring their task and Rx bins daily. I called patients with issues an prescribed the appropriate antibiotics for toothaches and UTI’S if needed. I also sent patients to the practice or ER if appropriate.
But then I was informed by corporate that I “wasn’t working up to the full capability of my license” (e.g. not billing) – so now I’m back to a couple of days seeing acute patients in office.
The poor practice and patients I was helping is back to drowning in tasks and Rx which don’t get addressed in a timely manner.
Let’s not do anything better or different or helpful for colleagues or patients…