I just had my first “yup, we’re now using an EHR” moment. I was working on populating Epic Problem Lists for the patients on the medical service I’m currently covering. A not un-common “problem” we see here is the ever-familiar “waiting for placement.” As we’ve all known for years, this is not considered a real diagnosis, and there is no ICD9 code. We’ve always skirted the issue somewhat uncomfortably by continuing to write it into our text-based notes, knowing that it is “not real medicine” and yet at the same time knowing that it best reflects the reality of the situation.
And so, populating an Epic Problem List in the wee hours of the morning, I tried this:
There is no fooling a computerized database of ICD9 codes. Welcome to the EHR. I’m curious to see how we all work out a solution to “waiting for placement” that both reflects the clinical reality and the economic/billing realities.
(Side-note: I am Aaron Neinstein, a fellow at UCSF in Endocrinology, and a guest blogger invited by Dr Cucina to participate in his live-blog of Epic go-live.)