Sounds like those questions the bank website asks me to prove I'm me...

Resident physicians are FLSA exempt not because of their salary, but because they're a "learned profession." So we get $40K to work up to 80 hours a week and take call up to every 3rd night, during which you are expected to go without sleep for up to 30 hours, for which there is no additional compensation. Sucks. And many of the calls are probably the IT equivalent of "I forgot my password." Things like "this medication that the patient isn't asking for because it's 3AM and they're asleep, it's about to expire, do you want to renew it?"

Afterwards, however, there are models where you get paid for call. We have a backup call system in our ER where a physician is a paid a set amount to carry the pager, then gets paid by the hour if they get called in. And I know another guy who gets paid a set amount to carry a pager for an inpatient psych unit here, then he gets paid per admission he sees the next day. As for me, I hate being on call, even if it's home/pager call, so I gravitate towards shift work.

for apps

and it really was the floor mat. Now I'm OCD about making sure it's in the right spot before I get in the car...

I absolutely loved BeOS! I mean, I love the MacBook I have now, but BeOS was my first love :-)

I don't own a netbook currently, but I would very likely buy one just to run BeOS/Haiku on it when it's ready. Basically, for me the OS would be the killer app that would entice me to buy the hardware.

At the VA, they require us to have a ridiculous number of strong passwords.

When you first start, you get a piece of paper that says:
Username
Password
Access Code
Verify Code
Signature Code
LMS Username
LMS Password
Met Username
Met Password

Then at the bottom it says "Remember within 48 hours." Yeah right.

Then the system forces you to change all of these passwords at varying intervals. So even if you start off by having all of the passwords the same, within a few months they're all different.

And they wonder why people write stuff down.

I wonder what will be the limit on the thermal sensors. I live in Texas and it would suck if I voided my warranty every time I walked outside with my laptop between the months of June and August. Or got into my 150-degree car after it's been sitting in the sun all day...

IAAD and I agree that confidentiality is extremely important, and health care professionals have a responsibility to safeguard PHI. However, I also think that IT admins have a responsibility to create an infrastructure that doesn't suck and that takes into account the needs of the people that actually need to use it. Because if it sucks bad enough, people will find a way to circumvent some of the safeguards in order to get their work done. Because it's human nature that getting one's work done is a more immediate need than theoretical concerns about privacy and confidentiality. So if you're going to develop an internal system, looking at what makes "the current hype" so popular might not be a bad idea.

For example, I work at a large county hospital/university system that has adopted groupwise. We are told that PHI is secure if sent through groupwise. However, besides the fact that groupwise is inherently sucky, they've made it extremely inconvenient for residents to use it. We cannot run the real client because we aren't allowed to have VPN access, so we have to use the web client, which has a horrible interface. It has a tiny storage allotment. They will not install the software that will allow it to work on the iphone. So, most people forward their groupwise email to their personal gmail or yahoo mail or whatever. Thus defeating the purpose of having the secure system.

Yes, it's wrong for the doctors to circumvent the security. However, I think it's just as wrong for the IT people to implement a system so crappy that people are driven to do this. Most doctors are thinking along the lines of "I have patients to take care of, I don't have all this time to spend fiddling with this crappy groupwise thing" not "let me violate HIPAA because I'm lazy."

That guy from Numbers does this almost every week.

If you think this is bad, consider that most electronic medical records pop up pointless warnings even more frequently. Sometimes they catch a legitimate error, but it's hard to not get conditioned to ignore those without really reading them.

I think I read some story many years ago about a boy who cried wolf... Same principle. Warnings cease to be effective if they pop up all the freakin' time for no good reason.

It's all Howard Wolowitz's fault.

Another explanation is that it's a failure in UI design on the part of the EMR. One should not have to be a computer geek/gadget freak in order to use an EMR. The same skills that lets someone type a word document or use a web browser should suffice. Most of the EMRs have horrible UIs and are not intuitive at all. I myself AM one of those gadget freak physicians, even wrote some of the templates in use at one of our hospitals, yet I still have difficulty figuring out how to do certain things.

But then, I'm a mac user. Perhaps my expectations are too high ;-)

I'm a resident physician, and so I've used various EMRs in different hospital and clinic settings, and they pretty much all suck in different ways. EPIC, which is based in Internet Explorer of all things, is the worst, but seems to the the one that's being adopted at the most hospitals.

The UI design is just horrible, but beyond that I had a hard time putting my concerns into words until I read an article somewhere that talked about something called "cognitive support to the physician." That is what most EMRs lack.

As a physician, I want an EMR that lets me rapidly get at important clinical information and give me targeted alerts that I need to make a decision. Instead, the systems are centered around billing and cover-your-ass medicolegal documentation. In the paper chart word, these issues had already diluted the meaningfulness of the chart. (Ever see a hospital chart - maybe 10-20% of it has meaningful clinical data in it, the rest is full of useless legal/billing/redundant crap.) Many EMRs just translate the same troubled paper chart system into electronic format, but then the ease of electronic data entry means that even more useless information is included/required, making it that much harder to find the info you really need to make a clinical decision.

I have to say that the best EMR I have used is still good ol' CRPS at the VA. It's not as slick looking as the newer ones, but the data is easily accessible and I have never had to waste my time looking up a billing code. It's been chugging along for over a decade, sharing data between hundreds of sites across the country. (And the issue in the first article about the EMR causing more deaths because you can't put in orders while the patient is en route - not an issue in CPRS, we do this all the time at our VA.)

My understanding is that the code for CPRS is open and free to anyone who wants it. I would gladly choose CRPS over the ability to type my notes with colored fonts in EPIC. They were considering adapting it for the large county hospital system where I work now, but in the end went with EPIC because... wait for it... it was easier for billing.