What it's like when your EHR shuts down

When a hospital's EHR went down recently, staff communicated with patients and one another more and cut down on unnecessary tests and documentation, a medical resident wrote in JAMA Internal Medicine.

Sofia Mettler, MD, a resident at Mount Auburn Hospital in Cambridge, Mass., recalled that when employees arrived at work one morning to find the Epic EHR not working, they panicked.

"Samples for the morning laboratory tests could not be collected because the phlebotomy team did not know which patient needed which tests," she wrote in the April 29 article. "Samples collected before the downtime could be processed, but the results could not be entered into the EMR system. Residents who need to review the records and assess their patient before the team rounds at 9 a.m. found themselves at a loss without access to patient medical records."

But they came up with a solution: They asked patients about their conditions overnight and nurses about how their patients were, according to Dr. Mettler. She questioned whether patients really required tests that had nothing to do with their conditions. The answer was no. For the one she needed, she faxed the order to the lab and got the results back within an hour.

She said the experience made her realize how much the EHR takes away time with patients and how much of healthcare is still done by actual humans.

"Our patient care on that day was the most patient-centered and most collaborative than ever in my 2 1⁄2 years of residency," Dr. Mettler wrote. "It was an epic day."

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