EMR: Electronic Medical Records or Extraordinarily Malicious Requirements?

It was with a heavy heart that I left the Notre Dame campus just a short while ago. The feeling was rather absurd because I have just this afternoon returned but I know I will experience the same feelings at the end of June. Why have I returned to Notre Dame, you ask? To play in the dirt, of course! I am thrilled to spend the next three weeks working on the Bailey Homestead excavation here in northern Indiana. But let's not get ahead of ourselves. Let me fill you in on what has been going on for the past month.

I was lucky enough to shadow my own primary care physician a few days a week these past four weeks. In just a short time, I have learned so much about medicine and the life of a physician. I also discovered three dreaded letters: E-M-R better known as electronic medical records. My first day on the job just happened to coincide with the second day of launching eClinicalWorks, one of many EMR programs.

Now, the common consensus states that EMR is the way of the future and will make everything easier on physicians. In the long run, sure, I can see it speeding up appointments and keeping things organized. However, on the short term, every single patient is a new patient. Even if they have been seeing the same doctor for thirty years, they are required to give their entire family history during their visit. Couple that with staff who were not raised with computers and it tends to cause a large headache.

Some physicians won't have too much difficulty with this because they have only a few patients who return every few weeks. But for family medicine physicians, some patients only have to come in every six months! This means that the transition will last for over six months, providing that all patients keep their appointments. It seems a big hassle now, but I still bear a shred of hope.

Even so, there are other issues with EMR. Doctors are some of the highest employing bosses. They need lab technicians, diagnoses coders, medical record keepers and more. With the advent of EMR, most of these roles are becoming automated. A nurse will not need to call down to medical records for a chart when a few clicks will pull it up. Nurses won't be needed to call patients with lab results when they are securely posted online and emailed.

I'm not sure about ObamaCare...it may benefit us in the end but from the evidence I've seen, I don't like it.

The Temptation of a Crunchy Leaf

Fall has definitely arrived here at Notre Dame. Despite the debut of the Starbucks red Christmas cups, I still feel like I'm just warming up to fall. Whether it is my obsession appreciation surrounding scarves or the satisfaction of that "Crunch!" sound as I step on a leaf, I have come to love fall.

There are so many different colors on this beautiful campus from the two evergreens that stand tall in the knoll behind my dorm to the bright red tree that I pass each morning as I walk to class. Especially on days like today where the sky is pure blue and it is a brisk 45 degrees outside, I have the intense desire to go sit in the sun -- after I grab a scarf or second jacket of course.

As far as scarves go, I feel that I may have a problem. That's the first step, right? Admitting you have an addiction to lovingly stitched, colorful scarves? In my dorm room at this very moment, I have eight. From off-white to hot pink to multicolored to a tasseled conglomerate, I have plenty of soft, fluffy variety. The guilty conscience in me is telling me to put at least one in the Project Warmth bin downstairs but I don't think I am quite secure enough in my scarf obsession to relinquish one. All in due time.

Some of you may ask, why on earth do I have so many scarves? There are several reasons. First of all, I knew that moving from the warm south to northern Indiana was going to be a big shocker to my system, therefore, I would need scarves in the winter. Once the collecting had begun, there was no stopping it. Once I was prepared with a  basic array of scarves--a few different kinds to blend with different types of outfits, of course-- I wanted more variety. If I am wearing a red blazer, I cannot wear my hot pink scarf.! Well, I could but...no. Therefore, I need to get a new scarf, otherwise, I won't be warm! Vain, I know, but there you have it. My scarf addiction was born.

Scarves aren't the only reason I adore fall up here. Stepping on a crunchy leaf is like a kind of mini-euphoric moment every time it happens. The administration recognizes the fantastic pastime of crunching leaves or--in better days--jumping into piles of crunchy leaves. In order to prevent crunch-seeking students, like myself, from jumping into the huge piles of leaves that are gathered each day around campus, if one is caught disturbing the tempting pile, you receive a ResLife (which is essentially a jacked-up demerit that goes on your permanent record and can prevent you from getting into graduate schools). Even with the threat of a ResLife, when the soft autumn sun sets on the tall piles of leaves dejectedly sitting out on the sidewalks whispering as the wind gently flows through them, merry crunching sounds can be heard by someone who knows what to listen for. (Not really, but wouldn't that be awesome?)

However, there are some things I do not like about the fall season, although they have little to do with the weather. Because there are lots of people like me who enjoy planning everything extremely far in advance, applications for summer programs and even programs for fall 2012 as all due in the fall months. Applications for NDVision were due before fall break (super competitive), International Summer Service Learning Program applications were due the 30th of October (waiting on a response!) and study abroad applications for Fall 2012 are due on November 15th! (Yikes! I haven't started that one yet!)

Do not forget about Operation Midterm: Round 3. Don't even get me started about the two exams I have next week and organic chemistry the following week. I cannot even think about finals yet.

So much to do and so little time! I think I'll go read a book on the knoll with one of my scarves. La ti da. 

Who me? I'm with Timmy.

Written on 10/18/11 while I was in Quito, Ecuador:

After two days of clinic here in Quito, I think our routine has been established. Wake up at 6:30am, shower, eat one piece of fresh crusty bread and one hard boiled egg for breakfast then off to clinic. in the evenings we have different cultural events scheduled to teach us more about Ecuador.

Last night, a little bit of the Schlitt family competitiveness surrounding card games made its appearance. Emily, an RN living in Ecuador who is our brigade coordinator, taught all 18 of us students how to play Cuarenta or forty, for the non-Spanish folk. Barely reminiscent of family pinochle games, Cuarenta was at the same time extremely intense and lighthearted when I we got the rules wrong. Spectacularly, my partner and I advanced to the finals in the brigade tournament but after our previous grand victories, our luck ran out and we were demolished. There will be a rematch...someway, somehow. [Edit: The rematch didn't occur in Quito but will be arranged on campus this fall.] It is in my blood not to go down in a card game without a fight.

Earlier yesterday I worked as a translator for the vitals and laboratory station. I can't remember how many times I explained la machine sue tomaría su presión de range. (blood pressure machine) While nervous at first because we were working with patients who could not speak a word of English, by the end of the day, the Spanish came more naturally to my lips. I even made a cameo translating for a doctor during a patient consult which was terrifyingly fantastic. Today I did not speak as much Spanish because I was working in the farmacía as a translator for the pharmacist and as a regular student worker. It was actually very useful because I learned a lot about different types of drugs and which names went with which illnesses. There were also long spans of time spent count in pills and sorting them into proper dosages. I think I can honestly say that I never want to count pills again! We spent enough time doing it that I will be counting dosages of 75 pills in my sleep!

This evening we went on a cultural adventure. Through a connection to Quito Eternál, an organization in Quito dedicated to preserving its historic center, we were able to snag a nighttime tour of the center of Quito. The art, the church façades, the guide's costume, the sights and all the stories made La Ruta de las Leyendas, the Route of Legends, one of the best tours I have ever been on! The art was particularly interesting because it was much more raw and realistic than art in most European Catholic churches. From the donated hair to the pillar of skulls (from top to bottom: skull with: pope hat, crown, cowboy hat cardinal hat, bishop hat and no hat) the artistry was less restrained and really added to the experience.

This trip has been worth every cent thus far and I cannot wait to go to clinic tomorrow and help the people in this area by making a real difference in their health care!

Travel Monkey Likes to Travel

I think I inherited the travel gene from my dad. In approximately twelve hours, I will be getting picked up to start my medical brigade in Quito, Ecuador for the week of fall break. Sponsored by the Timmy Foundation, I and about fourteen other students, two doctors, a PA, a pharmacist and a nurse will depart from the airport on our trip tomorrow morning to work in a clinic serving patients from around Quito.

This will be my latest traveling adventure in my infamous unspoken and unacknowledged 'continent contest' with my dad. He has always been a world traveler because of meetings and clients galore. Because he works so hard, we as a family have been able to travel with him. I'm positive that I inherited the travel gene.

You see, Dad and I have been neck and neck in our continent contest and at long last, I am about to pull ahead. (The contest may or may not exist only in my head, fyi.) At this very moment, we are tied. We have both been to Asia (Dad- China and more, Me- India), Africa, Europe, and North America. Dad has visited South America in the past but has not been to Australia. I was lucky enough to go to Australia with People to People Student Ambassadors back in 2003 sans parents. Recap: we're tied 5-5. Soon, I will be up to 6 continents! How blessed can one person be? How lucky am I to have a family that works so hard that I am able to do such amazing things?!

I cannot wait to go and serve the people of Quito in a medical setting. The chance to practice my medical Spanish combined with experiencing the culture of Ecuador is going to be fantastic. I am so proud of the Timmy Foundation's mission and am glad to be a part of it. I hope everyone has safe travels this fall break and I'll be back in a week! God bless!