Nurse: “I need help with the computer; patient transfer needs to be completed.”

Me: “Ma’am, the patient’s medications are on ‘MAR HOLD,’ which means Medication Administration Record Hold. Therefore, we cannot administer medication unless an attending physician releases this hold. Can we get the physician on the phone for him to reconcile the meds?”

Nurse: Reluctant to call the physician, insists on completing the transfer at the unit manager screen. Finally, she places a call to the surgeon and hands me the phone.

Me: “Dr. Smith, we are having issues with reconciling your medication request.”

Dr. Smith: In a voice of frustration, “I left the hospital. Can’t the nurse reconcile the medication? I know how to reconcile medication, but there seems to be something wrong with the system. Can you find someone else who can reconcile the medication?”

Nurse: Shoves another phone toward my face and exclaims, “It’s dietary.”

Dietary: “Please, educate the doctors to place diet orders in the system correctly! Patients are going hungry because they are doing it wrong.” Me: “Yes, I will do my best to teach them when I have the first opportunity.”

Dr. Anderson: Walks up to me and exclaims, “Can you help me order electrolytes? The pre-built order set is not set to our protocol.”

Dr. Robinson: “Why does the discharge prescription paper print at the location of the patient? What if someone takes hold of the script paper and forges my name? It should print at the location of the physician. You know what, I’ll just write the script paper.”

This is a typical day in the life of a physician informaticist when helping health care organizations implement new electronic health records (EHR). The process can be challenging, frustrating, and seemingly impossible to navigate. Often, the software needs to be fixed, and optimization of the software can seem painstakingly slow, which exacerbates the situation. However, a physician informaticist is the provider/end user’s advocate in the process. We continue to create ways to make the implementation process more effective and less stressful.

We want to improve physician satisfaction, and lessons learned to minimize burnout by being a bridge between the physician and the EHR during the implementation of the new system. We accomplish this by smoothing communication between clinical and operational staff. We have experience engaging with providers, allowing them to master the new electronic health records system.

In the scenario above with Dr. Smith, there was a glitch in the system, we placed a ticket for the issue with the technical team, and it was promptly resolved. I assisted Dr. Anderson in creating an order panel that reflected hospital protocol. After that was accomplished, I helped Dr. Robinson set up an e-prescription for controlled substances. Finally, I educated the providers on placing correct dietary orders as requested by dietary.

Afua Aning is a physician informaticist.

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