EHR Technology: A Play in two Acts

Casual Friday Fun Series (triggered by a serious post on THCB)

Act I:
A physician practice in Anywhere, USA
Doctor sitting at his desk, writing prescriptions. Pile of charts on table. Enter HIT Expert
HIT Expert: Doc, you should really stop writing prescriptions on paper and get one of those new ePrescribing tools.
Doctor: Eh... I've been doing this for 20 years....
HIT Expert: But, doc, you can make mistakes and kill patients....
Doctor: I don't make mistakes and I haven't killed anybody yet....
HIT Expert: The pharmacist can't read your scribbles. He could make a mistake... and think about all the typing he has to do to enter your scripts, and the patient will love to have the prescription waiting for him at the pharmacy...
Doctor: My patients have no clue which pharmacy they're going to... I can see the pharmacist's problem... (scratching head)
HIT Expert: You should try ePrescribing. You'll love it and it's free and the Government will pay you a couple hundred dollars to use it. What d'you say, doc? Wanna try now?
Doctor (bleary eyed, looking tired): OK, fine... What do you want me to do?
HIT Expert: Here... Log in here....just sign up here... type in a few things about your practice

Doctor typing, HIT Expert looking over his shoulder, Office Manager going in and out with papers, helping Doctor to type...

HIT Expert: All ready to go....Easy... Now write a prescription....
Doctor: Where?
HIT Expert: Right here. First you enter the patient name, and insurance, and pharmacy...
Doctor: I don't know what insurance he has... I just take care of him.... and I told you about not knowing the pharmacy...
HIT Expert: Here, it's in the chart... (leafing through chart) Type this.....(reading out loud BCBS plan and policy numbers)
Doctor: (typing) This is ridiculous.. was that a G or a Z?
HIT Expert: You only have to do this once. Next time the patient comes, it's all in the computer. Will save you lots of time...next time...
Doctor (looking puzzled): But I never had to do this before.....
HIT Expert: Do you want to computerize your records, or not? C'ommon doc, it's the 21st century....

Doctor keeps typing with HIT Expert looking over his shoulder...
Curtain.

Act II
Doctor at his desk, typing on computer. Pile of charts on table. Enter HIT Expert.

HIT Expert: How's it going doc? Like that ePrescriber?
Doctor: It's OK. My typing is much better now....
HIT Expert: I told you it will save you time... and the patients are safe now...
Doctor: I just wish it stopped popping these alert windows all the time...
HIT Expert: Just ignore them... Everybody does... I can show you how to turn them off...here....
(HIT Expert leans over computer and pushes a few buttons)
HIT Expert: Should be fine now... But that's not why I'm here... You need to get a registry, doc... It's the latest rage....
Doctor: That would be helpful... I'd like to see all my diabetics and how they're doing...
HIT Expert: Perfect... Here's one here... Very cheap... Just signup right here...

Doctor typing, HIT Expert looking over his shoulder, Office Manager going in and out with various documents....

HIT Expert: All set, doc.... Now you can track your little diabetics....
Doctor: Where?
HIT Expert: You have to enter them in the registry, doc... Here, you type their name, vitals, diagnosis... here's a place for lab results... and here's a place to type in their meds....wow, you can even type in their goals... and it has alerts too.....neat...
Doctor: But I already typed in their names and meds in the ePrescriber... doesn't the computer have them in there already?  Did you say more Alerts??? I thought you turned them off....
HIT Expert (with a polite laugh): It's technology doc....it will take hours to explain....you'll get used to it.... this here is the best registry out there and this here is the best ePrescriber out there... if you want the very best, and you do doc, trust me.... it takes some doing.... believe me, it will be worth it.... see how you love your ePrescriber now?.... you will absolutely adore your registry..... (walking slowly off stage)
Doctor: Hey, wait a second.... that's a lot of typing here.... why do I have to type the damn meds in there again.... (voice rising)...hey, Mr. Expert, where do I get the labs from? do you want me to type the labs in? and the weight and height too... (screaming).....I don't have time for this.... I have to see patients...

(Office Manager running in and out with piles of charts; Doctor typing furiously; group of angry patients, advancing from left, gesturing silently; HIT Expert running off right stage)
Curtain.

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Suggestions for Act III, IV to XXVI: HIT Expert comes back with  a Patient Portal, Lab results portal, Documentation, Quality Reporting, Bio-surveillance, PACS module, CPOE, HIE, NHIN.....