Nurse here. The software we chart with (that I’ve used at least - plenty out there I haven’t touched) ranges from meh to absolute shit. Some of the features on my wishlist would be elimination of redundant charting (like, if put the date down in one section, don’t fuckin ask in 3 others!), a way to save templates without patient-specific data, so when I do the same procedure on 5 different people, I can just click the template and fill in any holes instead of starting from scratch each time. Some actual standardization so different programs can actually talk to eachother. Like, ER, scheduling, preop, surgery, anesthesia, recovery, med surg, and sterile processing are all departments that might be involved in a single patient visit (checked into ER, sent for emergency surgery, then kept overnight for observation before discharge)… there’ll be some overlap, but scheduling, anesthesia, and sterile processing are usually each rocking their own unique software. The others are usually decently linked up nowadays, but still with the odd exception… like trying to get surgical updates from ICU so you know when to have a bed ready; but the chart is just dead and now a PACU nurse is calling report cuz the surgery finished 40 fuckin minutes ago, all because some some jackass in the ER left the patient’s chart open which locked everyone else out of signing their notes. Surprise!
…most of the issues with our charting software boils down to dumb shit like that - proprietary systems that are incapable of communicating, or just good ol’ fashioned garbage design. And it’ll stay that way, cuz oligopoly.
most of the issues with our charting software boils down to dumb shit like that - proprietary systems that are incapable of communicating, or just good ol’ fashioned garbage design
This is everywhere. I deleted a more thought out response when I realized that someone probably handed over ALL of the backend databases of patient data to an LLM (it’s HIPAA compliant so don’t worry *wink*) so that it can spew out MORE bullshit that doesn’t work, but a lot of money was paid for it so we’re going to use it.
As someone who’s worked with data from the backend of these systems I feel your pain. Why does someone need 10 different DoB’s over the course of 3 visits and why did those 3 day visits occur on 8 different days?
As a frequent patient I understand why everyone is always asking me my DOB excessively, to make sure they’ve got the right person and that I’m ‘with it’ enough to call the shots about my health, I assume? I guess that translates to paperwork too.
As a physical therapist, one thing that bugs me (and I know it’s not a software limitation but spending choices) is having to wedge my notes into a format designed for a physician or something else.
I got a small taste of that back in nursing school. Our care plans followed a very strict template for our clinical patients, and they were 100% geared toward med surg. My day in the OR made for an especially hard time trying to check all the boxes… I remember a whole lot of “yeah I didn’t asses for that, cuz pt was getting surgery… but, uh, here’s what I’d be looking for if I did! …uh, nope, no interventions, due to the patient still getting surgery, but here’s a few things I could have done if they weren’t being actively cut open”
Fortunately the profs were well aware of that dillemma, so they graded pretty soft on OR days lol. So, you’ve definitely got my empathy on this one - dealing with that garbage every day sounds like a nightmare!
…this is probably the core issue of why so many different departments end up using a completely different software package.
I work for a division of a health tech company and I can say that we hear you and value this kind of feedback. There are folks I work with who have dedicated themselves (including myself) to seek solutions to problems like these, and as a former integrations engineer, some companies are better at interoperability than others, despite the efforts of the HITECH Act in the US. My frustration is time and getting the attention of those who greenlight projects to work on things like these.
On one hand, I feel OSS could help solve these problems sooner, but on the other hand, healthcare has some very opinionated people and things could get messy.
Oi,I feel you so hard on this, as a software developer who works on medical devices and software used in medical contexts, holy shit the pickings are so bad.
Why can’t someone just conjure up solutions to all of this (which is totally doable technically)? Because FDA regulation forces us to follow Byzantine release processes and meet very exacting requirements for the software end product.
I could probably knock together at least two or three of your wishlist items in a week, and it would take 1-3 years for it to make it to the first customer. Even patches and fixes I build for existing products take 3-6 months to make it out the door after they’re done.
All of that to say, these make friction points that make it difficult for developers to coordinate and standardize without introducing mountains of extra bullshit that didn’t need to actually be in the product or software in the first place
It’s always been a fool’s errand to attempt software in the education or medical space. The requirements are too onerous and haphazard to be anywhere near worth it.
I’m edging around some of it in Ibis and Rufous, but yeah, I’m trying to avoid anything that needs direct FDA approvals which severely limits what I can build
Nurse here. The software we chart with (that I’ve used at least - plenty out there I haven’t touched) ranges from meh to absolute shit. Some of the features on my wishlist would be elimination of redundant charting (like, if put the date down in one section, don’t fuckin ask in 3 others!), a way to save templates without patient-specific data, so when I do the same procedure on 5 different people, I can just click the template and fill in any holes instead of starting from scratch each time. Some actual standardization so different programs can actually talk to eachother. Like, ER, scheduling, preop, surgery, anesthesia, recovery, med surg, and sterile processing are all departments that might be involved in a single patient visit (checked into ER, sent for emergency surgery, then kept overnight for observation before discharge)… there’ll be some overlap, but scheduling, anesthesia, and sterile processing are usually each rocking their own unique software. The others are usually decently linked up nowadays, but still with the odd exception… like trying to get surgical updates from ICU so you know when to have a bed ready; but the chart is just dead and now a PACU nurse is calling report cuz the surgery finished 40 fuckin minutes ago, all because some some jackass in the ER left the patient’s chart open which locked everyone else out of signing their notes. Surprise!
…most of the issues with our charting software boils down to dumb shit like that - proprietary systems that are incapable of communicating, or just good ol’ fashioned garbage design. And it’ll stay that way, cuz oligopoly.
This is everywhere. I deleted a more thought out response when I realized that someone probably handed over ALL of the backend databases of patient data to an LLM (it’s HIPAA compliant so don’t worry *wink*) so that it can spew out MORE bullshit that doesn’t work, but a lot of money was paid for it so we’re going to use it.
As someone who’s worked with data from the backend of these systems I feel your pain. Why does someone need 10 different DoB’s over the course of 3 visits and why did those 3 day visits occur on 8 different days?
As a frequent patient I understand why everyone is always asking me my DOB excessively, to make sure they’ve got the right person and that I’m ‘with it’ enough to call the shots about my health, I assume? I guess that translates to paperwork too.
Thats why they ask you yes.
They them have to fill out forms on the visit and are asked there multiple times.
As a physical therapist, one thing that bugs me (and I know it’s not a software limitation but spending choices) is having to wedge my notes into a format designed for a physician or something else.
I got a small taste of that back in nursing school. Our care plans followed a very strict template for our clinical patients, and they were 100% geared toward med surg. My day in the OR made for an especially hard time trying to check all the boxes… I remember a whole lot of “yeah I didn’t asses for that, cuz pt was getting surgery… but, uh, here’s what I’d be looking for if I did! …uh, nope, no interventions, due to the patient still getting surgery, but here’s a few things I could have done if they weren’t being actively cut open”
Fortunately the profs were well aware of that dillemma, so they graded pretty soft on OR days lol. So, you’ve definitely got my empathy on this one - dealing with that garbage every day sounds like a nightmare!
…this is probably the core issue of why so many different departments end up using a completely different software package.
I work for a division of a health tech company and I can say that we hear you and value this kind of feedback. There are folks I work with who have dedicated themselves (including myself) to seek solutions to problems like these, and as a former integrations engineer, some companies are better at interoperability than others, despite the efforts of the HITECH Act in the US. My frustration is time and getting the attention of those who greenlight projects to work on things like these. On one hand, I feel OSS could help solve these problems sooner, but on the other hand, healthcare has some very opinionated people and things could get messy.
Oi,I feel you so hard on this, as a software developer who works on medical devices and software used in medical contexts, holy shit the pickings are so bad.
Why can’t someone just conjure up solutions to all of this (which is totally doable technically)? Because FDA regulation forces us to follow Byzantine release processes and meet very exacting requirements for the software end product.
I could probably knock together at least two or three of your wishlist items in a week, and it would take 1-3 years for it to make it to the first customer. Even patches and fixes I build for existing products take 3-6 months to make it out the door after they’re done.
All of that to say, these make friction points that make it difficult for developers to coordinate and standardize without introducing mountains of extra bullshit that didn’t need to actually be in the product or software in the first place
It’s always been a fool’s errand to attempt software in the education or medical space. The requirements are too onerous and haphazard to be anywhere near worth it.
I’m edging around some of it in Ibis and Rufous, but yeah, I’m trying to avoid anything that needs direct FDA approvals which severely limits what I can build