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The inevitable march of progress does not necessarily mean improvement. The arrival of computer generated collation and order certainly has made it easier to have all data at the physician’s fingertips; but at a price. Writing orders, discharging patients, transferring patients and documenting in the electronic record has slowed down the delivery of good practical health care. 

For example: Patients cannot be taken out of the O.R. until all charting is completed by the nursing staff. This of course means jumping from one page to another as well as switching functions; all of which takes inordinate amount of time while the O.R. time and bill increases.

                            Writing orders has become a lengthy exercise in trying to fit precise orders in the context of the program being used. This takes time away from more useful direct patient care. Yes orders need to be legible (probably the main inspiration for computer use!) but wouldn’t a typing program like WORD give the physician the ability to communicate as specifically as he wants in much less time.

I see the nursing staff , of highly competent and trained people, spending at least half their time at the bed-side looking at the computer instead of the patient. This is no fault of their own.

The emphasis has switched to electronic documentation from enthusiastic doctoring. All in the name of legality. Paperless care sometimes means less care.