I’m an early adopter of technology and an eternal optimist that the next program, app, or device I try is going to be the one that gives me back time. Today, I’m going to tell you 3 ways to use technology to bring order back to the chaos that is residency and clinical practice. My disclaimer is that I have no data, other than anecdotal, to back up my claim and I have no financial conflicts of interest to disclose.
1. Create an electronic filing cabinet.
As surgeons, our lives are busy, unpredictable, and we work in multiple environments. Data comes to us at all times in many different forms and we need a place to archive things in a usable way. Let me introduce you to Evernote and Onenote. These 2 programs archive text, images, and audio (Evernote) to allow you to access data from a mobile device, laptop, or desktop. You can read about Evernote and Onenote from the links, while I focus on use cases.
Archiving Journal Articles: Both of these programs have web clippers for browsers that lets you send a pdf directly into the program. In both programs you can highlight within the document, make annotations, and denote key findings that are then searchable through the program interface. You can use tags to cluster articles on similar topics together to locate them. Additionally, you can share the articles through the program interface with colleagues as needed. The pdf’s are embedded into the program, as well, so you can drag and drop into your favorite reference manager (EndNote and Pages allow PDF dropping).
Keeping Track of Licenses: I use Evernote for ACLS, BLS, ATLS, NPI, DEA, medical license, med school transcript, residency graduation certificate, awards, …you get the idea. Snap a picture of the card, tag it in the program, and now you’ve always got the card with you. In Evernote, you can even set up a reminder to notify you whenever the card is about to expire so that you can renew.
Case preparation: As a resident, I created a file for every type of case I scrubbed. At the end of a case I would take a picture of the attending preference card and then make notations on attending preferences. I’d then take the op notes (without patient identifiers of course) and put these into the case files. Over time, I moved my preferences to the top of the list so when I began practice my case cards and operative note templates were ready to go. A note to the residents, reviewing this information immediately prior to a case was useful because the farther I was able to take a case in the style of the operating attending, the more comfortable they were in letting me do the case independently.
The more you dump into these programs the less mental RAM you are using. It helps me not have to keep worrying that I will forget something or not remember to complete a task. If you want to get really efficient combine these services with IF THIS THEN THAT, an app that creates recipes that allows the apps you use every day to communicate.
2. Be able to work or teach from anywhere, on any device.
Who hates turnover? You can’t get back to your office or workroom and you didn’t mess with bringing your laptop since you should be in cases all day. Instead of just checking email on your phone, why not be prepared to get some major work done or seriously improve those teaching evaluations? Enter online storage like Box and Dropbox.
OK, you have probably heard of these before, but who knew that Box obtained HIPAA and HITECH compliance in 2012 and that both of these services integrate with Microsoft Office Online to allow for Word, Excel, and Powerpoint editing through the web interface? Also, a lot of universities have Box enterprise integration (that means 50 GB of free storage) so check with your local IT folks to see if you have access.
Getting work done: I use the web interface of box to edit manuscripts (including citations with online reference managers), analyze data in Excel, and create presentations. You can even do this on the hospital thin client devices since everything is based in the cloud. Same can be said for Dropbox, just have to be careful about HIPAA issues.
Teaching: I find it hard to learn and teach Surgery without images; I need to see what someone is talking about. You can create a repository of teaching images or talks in either of these services and you’re always prepared to teach during any downtime.
If you’re not on call, turn on the do not disturb feature of your cell phone and put it down. We’ve all heard of distracted driving, I think we surgeons practice distracted living. I find I’m so focused on reading one more email, answering one more question (that wasn’t urgent), or doing one more thing on my device that I am not present in the moment.
In the operating room: Talk to your team. We’re accustomed to questions throughout operations, however, next time talk to the circulator and ask they tell any physicians calling with a question or consult that you’re in the operating room and the time the case is supposed to end and have them ask the person if the question can wait until the procedure is completed. I leave the circulator a notecard so they can write down all of the messages in one place. You’ll be surprised how much this can cut down on distracting intraoperative phone calls.
I’d love to learn how you use technology to improve efficiency and productivity. Please leave comments below or tell me on Twitter @kwsexton.