Electronic Medical Record Is Down…

5:51 am. That was what the clock read. Okay, I thought to myself, 30 more minutes to snooze. Mini cat naps, on and off. 6:21 am. Time for me to get out of bed.

“Today is going to be a good day. I’m going to do my best to take care of my patients and finish my charts on time.” Since cutting my charting time and being able to redirect my brain intentionally, I have been saying this to myself all the time.

I casually strolled into the clinic. As usual, I was the second person to arrive. After gently put down my bags, I washed my hands, wore some size small gloves, and started cleaning my work station with Chlorox wipes. This has been the routine since the pandemic.

The next step was to turn on my computer and log in. As I was thinking that my 10-minute pre-clinic regimen was over, I realized that the icon for the EMR program was missing on the desktop. Alright, this had happened before – all I had to do was to refresh the “recovery icon”. Did that, and nothing happened. Hmm. Interesting. Before my mind could wander some distance, I heard a familiar voice.

It was Lisa. Lisa works for the EMR company. Before that, she worked in our office for more than 5 years. She broke the news that the EMR program had a scheduled upgrade overnight, and was supposed to be up and running again by 8 am. Alright, just 20 more minutes, things would be back to normal.

The first patient arrived at 7:47 am for his 8 am appointment. The front staff was not able to check him in online. Somehow the backup read-only system was only partially functional (maybe it needed a backup system itself). We just got word that EMR would be down until 10 am.

EMR downtime is like a construction project. If the contractor tells you they will complete that project in 10 days, most of the time you need to add another 5 days, or more. So when we were told that EMR would be functional at 10 am, I did not think it would happen.  

I gathered my team – my nurse and my medical assistant. I said, “This is just one of the many surprises we get from time to time. There are always surprises in life. We are going to do what we can, and we are going to finish on time!” That was me implying that no complaining was allowed. The situation was such, and that we couldn’t change it at the moment; but we could do our best and we could be creative about it. By dwelling in the mode of “this shouldn’t have happened” was not helping things.

Thankfully I entered all the lab orders for today’s patients a few days ago. Miraculously, we discovered the lab orders appeared in the backup system.

The medical assistant walked my first patient into the exam room. While she was taking the vitals, my nurse asked her usual questions about any updates or changes since the last visit.

Truly grateful that our CBC machine is a completely separate entity from the EMR. What is a hematologist going to do without her complete blood count results right away? It is like a cardiologist without an EKG in the office.

We were moving along smoothly, minus the electronic documentation. I knew my patients well enough to order any additional imaging studies or other extra tests. It was almost as if I had the EMR in front of me. Some patients commented on the fact that we were operating without the EMR. I told them that excitements happen here sometimes. We still bonded with the human connection, more than merely a relationship between a doctor and a patient.

10:36 am. Still no EMR. I was determined. Today was going to be a good day. I didn’t need a functional EMR to make my day. I was ready to take on any curveball thrown at me. I was capable. I would figure things out. EMR would eventually be ready. I would make up the charting time.

Ten patients later, the EMR was operational again. Alright! I would make up “lost times” somehow. Catching up the EMR messages, lab results, phone calls, and of course, documentation for the patients’ visits.

Even though I left my office one hour later than usual, it was a triumphant day to celebrate. I celebrated that my team did not moan or fuss (at least not in front of me). We all focused on doing our jobs the best way we could, given the resources available. I celebrated that I didn’t have to stay more than an hour later. I celebrated that I was able to keep things light-hearted and invited my patients to join in that merry spirit. No one died when the EMR was down. If I could thrive in the EMR-deficient zone in this heavily electronic dependent world, what else was possible?