I cover a 15 bed ICU in one of the states you mentioned and have seen the discrepancy as well.
I noticed, starting in 2020, that our hospital's internal ICU bed-available data did not correlate with local press/internet data. I have access to internal, real-time, system-wide ICU bed-available data. (I'll say that we have some where between 10-25 hospitals, don't want to be specific as I don't know what management would think of posts like this on HN). Our internal system-wide data does not correlate very well with state-wide press/internet metrics either.
When on-shift I spend much time trying to find beds for patients as well as fielding calls from other hospitals that are trying to do the same. The data available on the internet and in the press does not reflect the situation in the trenches at all in our region. I'm not sure how it could as our internal situation changes every 10-15 minutes, sometimes, depending on the progress or deterioration of individual patients, staffing availability, discharges home, numbers of people waiting to be cared for, what day of the week it is (Fri, Sat, Sun, Mon are the worst), how bad the roads are, what time of day it is (most people arrive in the afternoon and evening), if a holiday has just ended, if a large/local event has ended (people tolerate terrible symptoms for holidays and events and come to the ER afterwards).
For the entire pandemic, the real-time in-hospital situation has been more dire than is reflected in the press or on data-accumulation sites like Johns Hopkins. It has been exhausting.
>Wow. How do they let this happen? Google never deletes an email.
I'll add that the deleting of signed orders in the background I witnessed occurred a few EHR upgrades ago but after we had been using the EHR for 3-4 years. However, in a high-risk setting like a hospital, once you witness that happen, you forever feel like you have to be on-guard with the EHR for the sake of patient safety. Trust but verify, etc.
>If paper flows are better, why haven't they reverted to paper.
Most of us would love a return to paper but this is not allowed in the US by government regulations unless the EHR has gone offline or is failing in real-time.
-The UI of Cerner's product is inconsistent and maddening. A constant experience is that on some screens one must right click to open up extra data fields for entry but elsewhere they open on their own.
-The UI is often randomly changed and one must figure it out again. We would really like reliable tools.
-Latency is substantial.
-Simply reading data is frustrating because popups occur everywhere. We were told that a way to use Cerner is to hover to get a popup with more info. This is rarely useful. What happens is that popups get in the way of what you are looking for.
-Between Cerner Powerchart, the desktop login software, and dictation software there are random roadblocks several times daily. Something won't load or fails, or has a moment of 10x latency, or crashes. This is frustrating since we are trying to help seriously ill people and these tools are random/chaotic.
-Anyone using EHRs know that the EHRs make mistakes, delete things. I've caught the EHR deleting signed orders in the background that I had to reorder. Initially I thought I must be starting to forget to order things on patients or was going crazy. But, when our quality people played back my actions in the EHR (at my request) they could see that I had used it properly and the EHR had deleted orders. We have to overwatch the EHR for safety reasons.
-EHR is a recruitment issue. Some practitioners have bypassed us because of the EHR we are required to use.
-Productivity is at least 3x lower with the EHRs compared to paper flows.
-The EHR contributes to practitioner burnout for many reasons. It is frustrating and exhausting to use. It is random and chaotic.
If anyone from the EHR vendors, login vendors, dictation vendors, or overwatching government agencies are reading (and that might care) I plead with you to improve the nearly uniformly terrible EHR/EMR end-user situation.
This. I'm a doc covering our ICU and I'm seeing an endless stream of Delta COVID-19 patients which are 95% unvaccinated and younger than in 2020.
There are many socio-politico-scientific issues/stories surrounding SARS-CoV-2 but, in my opinion, the most dangerous impact of this virus is the ability it has to massively deplete medical resources in a region. In real-time, SARS-CoV-2 is saturating our beds/resources and burning-out staff. No staff have been dismissed from our healthcare system (~20 hospitals) due to unvaccinated status and nurse staffing has been critical since spring of 2020. Considerable effort is expended daily just to find staffed beds for patients within our hospital (or within our region if we are at max).
(Have been a long-time reader of HN and this is my first post. Just want to thank everyone for a great community over the years. Well done.)
I noticed, starting in 2020, that our hospital's internal ICU bed-available data did not correlate with local press/internet data. I have access to internal, real-time, system-wide ICU bed-available data. (I'll say that we have some where between 10-25 hospitals, don't want to be specific as I don't know what management would think of posts like this on HN). Our internal system-wide data does not correlate very well with state-wide press/internet metrics either.
When on-shift I spend much time trying to find beds for patients as well as fielding calls from other hospitals that are trying to do the same. The data available on the internet and in the press does not reflect the situation in the trenches at all in our region. I'm not sure how it could as our internal situation changes every 10-15 minutes, sometimes, depending on the progress or deterioration of individual patients, staffing availability, discharges home, numbers of people waiting to be cared for, what day of the week it is (Fri, Sat, Sun, Mon are the worst), how bad the roads are, what time of day it is (most people arrive in the afternoon and evening), if a holiday has just ended, if a large/local event has ended (people tolerate terrible symptoms for holidays and events and come to the ER afterwards).
For the entire pandemic, the real-time in-hospital situation has been more dire than is reflected in the press or on data-accumulation sites like Johns Hopkins. It has been exhausting.