Death By a Thousand Clicks? Not Dr. Bob, Who Navigates a Template-free EHR

Death by PowerPoint: Overly used templates filled with a variety of bland information that does little to emphasize the point of the presenter. In this scenario, slides are often filled with generic information that could have been excluded the presentation in the first place had the speaker actually taken the time to time the point he was trying to make.

Likewise, there’s “death by a thousand clicks.” Pretty close to the term “death by a thousands cuts.”

The oft used phrase is usually mentioned by physicians, practice leaders, members of the health IT community and nearly everyone to interact with a template-filled electronic health record. It’s derived from the seemingly endless clicking as a user navigates the encounter note in the respective system, or so the story goes.

Click after click after click of the same, repetitive information in case after case, even if two patients present with the exact same conditions on the same day. No matter, when using a template system, you’ll be forced to re-key every piece of detail and click the exact clicks as the previous encounter, no way around it.

All the clicking reminds me of a cartoon I saw recently. It goes something like this: a doctor goes to his doctor for an exam. “What seems to be the problem,” the presiding doctor says to his doctor patient. The doctor patient replies, “Well, doc, I think I’ve developed a case of carpal tunnel syndrome from too many clicks in my EHR.”

I recently met Dr. Bob. Those of you with a Praxis system know who I’m talking about. In actuality, Dr. Bob is nothing more than a mascot for Praxis, which is the maker of template-free EHRs.

After ridding his practice of paper, Dr. Bob celebrates because of his decision to implement some technology. However, he quickly finds himself boxed in by templates and non-customizable data fields populated by click after click. “The templates soon bogged him down. Everything was a drop down menu or pick list. His thoughts had to pick one of the options. There was no flexibility.”

Templates slowed Dr. Bob down. Dr. Bob felt more like he was becoming more like a data entry clerk than a physician.

Sound familiar?

I thought so.

The Praxis system is written by its users in free text. The more it’s used, the easier the system is to use, remembering data from an earlier note and it essentially begins to auto populate certain data that can then be customized and changed given the varying scenarios encountered during the visit.

The system allows you to enter a few minor details like condition or medication as you to build a case. The system remembers the details of each encounter and when you enter similar details again in the future, it helps you populate the field.

And the “thinking” the Praxis system does on behalf of the user is essentially the same as what you’d find when using Google to search the web. For every search conducted, Google remembers your past searches and auto populates what it thinks you are attempting to find. And, as you type, Google offers suggestions for what you might want to see.

From the demo, it’s clear the template-free system has its advantages and certainly would alleviate the some of the click, click, clicking. For some users, though, they may not enjoy the freedom the system seems to provide as it seems to provide the exact intuitiveness that so many EHR users seem to crave.

All in all, it’s intuitive, fast, and – in my opinion – pretty slick.

So, for those of you seeking more flexibility in your system and wanting to do away with the endless clicks and data administration, the Praxis system seems pretty cool.

And for the record, Praxis had nothing to do with this post; the company didn’t know I was writing it.

This one is on the house. Enjoy.

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