An Argument for the Enforcement of Electronic Health Record Cross-Communication

Image credit: Pexels

Author: Haig Aintablian, MD
AAEM/RSA President
Originally published: Common Sense September/October 2019


A 77-year-old patient comes into the ED for a complaint of shortness of breath x 6 months. This is the first time the patient has come to this hospital and there are no medical records in the EHR. The patient doesn’t remember what problems they have, but they know they’re on some sort of medication for their heart. They deny any kidney problems. You optimize the patient in the ED, see no acute ECG changes, no troponin elevations, but a creatinine of 2.3 and a BNP that is mildly elevated. You admit for heart failure and AKI. Multiple renal and cardiac studies are done in house because his records can’t be retrieved. Once they are retrieved you see that his BNP and Cr are within baseline and the patient did not require admission.

Why Did AAEM Take a Stand Against APP Independent Practice?

Author: AAEM APP Task Force

Physician members of the American Academy of Emergency Medicine have voiced concerns about the use of advanced practice providers (APPs) in the emergency department and their push for independent practice without the supervision or even availability of a physician. The task force spent hours discussing the issues, comparing the education of physician assistants, nurse practitioners, and board-certified emergency physicians, speaking to physicians about their concerns, and examining the literature. (J Emerg Med 2004;26[3]:279; Acad Emerg Med 2002;9[12]:1452; J Emerg Med 1999;17[3]:427; Acad Emerg Med 1998;5[3]:247; Ann Emerg Med 1992;21[5]:528.)

Most emergency physicians have worked with APPs and appreciate that they are talented clinicians who improve emergency department flow, efficiency, and quality of care under the guidance of the emergency physician-led team. Many emergency physicians are aware of situations that place APPs in clinical environments that are beyond their capabilities, level of training, and even scope of practice. This is not the quality of care our emergency patients deserve.

AAEM/RSA 2017 Award Winners

RSA Secretary-Treasurer, Philip Dixon, MD (left) with AAEM/RSA Program Director of the Year Award recipient,
Jonathan S. Jones, MD FAAEM (center), and AAEM/RSA Resident of the Year Award recipient,
Mary Haas, MD (right)

Author: Michael Wilk, MD

Congratulations to our AAEM/RSA award and scholarship winners from this past year! All of them have made outstanding contributions to their programs and/or RSA over the past year and we are pleased to recognize them.

AAEM/RSA Program Director of the Year Award
Jonathan S. Jones, MD FAAEM, Mississippi University

To nominate your program director next year: http://www.aaemrsa.org/get-involved/residents/program-director-of-the-year-award

AAEM/RSA Program Coordinator of the Year Award
Krista Fukumoto, Stanford University

AAEM/RSA Resident of the Year Award
Mary Haas, MD, AAEM/RSA President, PGY3, University of Michigan

AAEM/RSA Committee Member of the Year AwardJake Toy, MS3, Copy Editor, Social Media Committee.

AAEM/RSA Medical Student “Why EM?” Essay Scholarship Winners:

• Hannah Wolsiefer-Leak, MSIV, Indiana University
  http://aaemrsa.blogspot.com/2017/02/aaemrsa-medical-student-scholarship_16.html
• Yasmeen Elmelige, MSIV, Morehouse School of Medicine:
  http://aaemrsa.blogspot.com/2017/02/aaemrsa-medical-student-scholarship.html

For information for medical students to apply next year visit: (http://www.aaemrsa.org/get-involved/students/medical-student-scholarship)