I actually find a really brief thank you sweet, it’s the 2 to 3 page consultations that make me wonder why we don’t have a character limit. I also feel bad telling people to come in when we have such jammed schedules in primary care and appointments are booked for weeks, but it’s another illustration of “Don’t hate the player. Hate the game.”
2 to 3 page consults? I wish. Try 10-15 pages (or more) with every test available copied and pasted into the note. And the only info useful to me, a few lines in the Assessment and Recommendations.
Just say test results reviewed, mention relevant high points. Spare me endless scrolling to find what this expert's NP says to do.
Gigabytes, no Terabytes of useless and repetitive info in these EHRs
I totally agree. Having to scroll through endless past medical history, past surgical history, a list of procedures, and however many imaging tests in full takes time. I typically read HPI and then Assessment and Plan. Just give me the highlights, the details and the important, what are you going to do about it. Please and Thank You!
Don't feel bad asking patients to come in. Your time and attention is valuable. Any question that is roughly more than a yes or a no has a very low threshold into being turned into a visit. Patients learn to respect your attention very quickly. It's also not a limitless supply. Tellemd is also a nice way to handle some of these. Documentarion is better and can expand to ordering testing or treatment and I feel much less beleaguered.
PS I also don't call pts to let them know their refill was sent unless there is a good reason. It's not a realistic expectation given today's circumstances.
Thank you Kim, this original post and your comments are empowering and validating. I also think that trying to please and serve through a seemingly endless inbox of messages is ultimately bad for the patients, too.
One of the understandings I have as a patient with my PCP is, there's no reason at all for him to call me regarding labs. I'm perfectly capable of looking at those when they hit the EHR and review them myself. And it saves him another 15 min at the end of a long day. As a patient, I'm conscious of the time constraints in clinical practice. But if I seek an appointment, there's actually a good reason for it, which he understands.
Epic is the best of the EHRs I've used. That merely means the bar is so low. Once upon a time, OpenEMR was looking promising but you have to have access to a company to blame and open source software, regardless of how well it works or is standards compliant, just doesn't have that "one throat to strangle" feel. So, Epic is "the best of the worst".
The acknowledgment of receipt aspect is important. If you dislike 'Thank you', then write 'Received and reviewed' or 'Acknowledged'. I would not simply trust the metadata involved with your clicking 'Done' or clearing an in-basket queue in your EHR. (I'm a physician and an attorney, in full disclosure.)
Epic Secure Chat provides information on the recipients who have opened the message and read it. This confirms the receipt without the need of any further action. Epic has also added emojis which don’t trigger a response to the sender, it acknowledges the action taken by the recipient. I hate responses that don’t convey a meaningful medical action, it’s disturbing and adds to the clinical work. I do enjoy social interactions with the healthcare team, but not using the EHR.
Holy cow, thank you for writing this. I'm a patient and am very grateful for the excellent care from my nurse practitioners and I've always sent a little Epic thank you message at Christmas time. I can see now how they'd become a problem. So, what would be the best way to say thank you without adding to their workload? My thought was to make an appointment, say thank you, hand them a real Christmas card, and tell them to relax or do something fun until their next appointment. I'd love to hear your ideas.
If your post or email or whatever communication starts with “this is awkward,” then perhaps you should choose to finish typing up your communique and then hitting the delete button.
Reading this post wasted a lot more of my time than reading a simple “thank you.”
Have a “Thank you” radio button for customers/patients to press at the end of reading the message. Then, have a system counter of those for the persons and throw it up on a board to track how many “Thank you” hits personel received over the course of a designated time, like quarterly and annually, and then reward the winner for doing work deserving of their patients’ gratitude? Think about it? 🙂
Thank you.
😜Just kidding! Sorry.
I actually find a really brief thank you sweet, it’s the 2 to 3 page consultations that make me wonder why we don’t have a character limit. I also feel bad telling people to come in when we have such jammed schedules in primary care and appointments are booked for weeks, but it’s another illustration of “Don’t hate the player. Hate the game.”
We have a character limit on our patient messages....they just send it over 3 messages ; )
Where there is a will there is a way.
2 to 3 page consults? I wish. Try 10-15 pages (or more) with every test available copied and pasted into the note. And the only info useful to me, a few lines in the Assessment and Recommendations.
Just say test results reviewed, mention relevant high points. Spare me endless scrolling to find what this expert's NP says to do.
Gigabytes, no Terabytes of useless and repetitive info in these EHRs
Or, as I've been heard to mutter, "Never say in 10 words that which can be expressed in 10,000."
I totally agree. Having to scroll through endless past medical history, past surgical history, a list of procedures, and however many imaging tests in full takes time. I typically read HPI and then Assessment and Plan. Just give me the highlights, the details and the important, what are you going to do about it. Please and Thank You!
Don't feel bad asking patients to come in. Your time and attention is valuable. Any question that is roughly more than a yes or a no has a very low threshold into being turned into a visit. Patients learn to respect your attention very quickly. It's also not a limitless supply. Tellemd is also a nice way to handle some of these. Documentarion is better and can expand to ordering testing or treatment and I feel much less beleaguered.
PS I also don't call pts to let them know their refill was sent unless there is a good reason. It's not a realistic expectation given today's circumstances.
Thank you Kim, this original post and your comments are empowering and validating. I also think that trying to please and serve through a seemingly endless inbox of messages is ultimately bad for the patients, too.
Thanks again 💪
One of the understandings I have as a patient with my PCP is, there's no reason at all for him to call me regarding labs. I'm perfectly capable of looking at those when they hit the EHR and review them myself. And it saves him another 15 min at the end of a long day. As a patient, I'm conscious of the time constraints in clinical practice. But if I seek an appointment, there's actually a good reason for it, which he understands.
Epic suppresses thank you messages now. Organizations can choose whether to enable this.
Another reason to hate Epic
Epic is the best of the EHRs I've used. That merely means the bar is so low. Once upon a time, OpenEMR was looking promising but you have to have access to a company to blame and open source software, regardless of how well it works or is standards compliant, just doesn't have that "one throat to strangle" feel. So, Epic is "the best of the worst".
Add this at the end of each message: NO NEED TO REPLY
No thanks......
The acknowledgment of receipt aspect is important. If you dislike 'Thank you', then write 'Received and reviewed' or 'Acknowledged'. I would not simply trust the metadata involved with your clicking 'Done' or clearing an in-basket queue in your EHR. (I'm a physician and an attorney, in full disclosure.)
Epic Secure Chat provides information on the recipients who have opened the message and read it. This confirms the receipt without the need of any further action. Epic has also added emojis which don’t trigger a response to the sender, it acknowledges the action taken by the recipient. I hate responses that don’t convey a meaningful medical action, it’s disturbing and adds to the clinical work. I do enjoy social interactions with the healthcare team, but not using the EHR.
Holy cow, thank you for writing this. I'm a patient and am very grateful for the excellent care from my nurse practitioners and I've always sent a little Epic thank you message at Christmas time. I can see now how they'd become a problem. So, what would be the best way to say thank you without adding to their workload? My thought was to make an appointment, say thank you, hand them a real Christmas card, and tell them to relax or do something fun until their next appointment. I'd love to hear your ideas.
As a nurse practitioner one of the best things I have ever received from a patient is a handwritten note. She sent it to me through the mail.
Amen!
Thank you! He he he. Couldn't resist. 🤣
Add this at the end of each message: NO NEED TO REPLY
Nonsense, a simple thank you is a courtesy. that humanizes a binary world...How about adding a please when asking for something.
If your post or email or whatever communication starts with “this is awkward,” then perhaps you should choose to finish typing up your communique and then hitting the delete button.
Reading this post wasted a lot more of my time than reading a simple “thank you.”
Nice. Thank you, Michal.
Idea!
Have a “Thank you” radio button for customers/patients to press at the end of reading the message. Then, have a system counter of those for the persons and throw it up on a board to track how many “Thank you” hits personel received over the course of a designated time, like quarterly and annually, and then reward the winner for doing work deserving of their patients’ gratitude? Think about it? 🙂
Have a Merry Christmas and Thank You!