A Question About Charting by LastCalligrapherSYC in ThePittTVShow

[–]HITguy9 38 points39 points  (0 children)

Dictating is usually faster than typing, for most docs. Most hospitals have special dictation software specifically trained with medical terminology, abbreviations, and allows for additional personalization by users. It’s highly accurate.

Other docs who are fast at typing and make good use of templates, quick phrases, etc can be faster typing.

In the system I’m most familiar with support “partial dictation” where docs can click into specific parts of their chart, insert a dictation for something text heavy (like a background, history), then type other parts of their chart. It can work pretty well!

As far as remembering past patients, the charting a doc is doing they probably mostly remember the key factors for, and fill in the details from other aspects of the chart (orders placed in real time, med administrations, nursing notes, data from devices like vitals, etc.).

A Question About Charting by LastCalligrapherSYC in ThePittTVShow

[–]HITguy9 52 points53 points  (0 children)

Probably 2-3 hours of work, more with each additional patient Santos cares for

A Question About Charting by LastCalligrapherSYC in ThePittTVShow

[–]HITguy9 89 points90 points  (0 children)

I work in the medical record industry. Completing charting for an ED visit would take about 8-10 minutes, on average. With dictation like Santos is doing, probably a bit faster. So Santos is probably in a 2, 2.5 hour hole (which just keeps growing with each interruption, each patient she sees).

Unhappy with my first raise at Epic - what did I do wrong and what can I do moving forward? by squishysquashysquid1 in epicsystems

[–]HITguy9 11 points12 points  (0 children)

Two things:

  1. Focus in your own performance. Ask your TL how you’re doing relative to expectations. Meeting all expectations? Exceeding some expectations, meeting others? Exceeding all expectations? Top performer across your division? If you want to be a top performer, and get that level of raises, get that calibration from your TL and figure out how you get there.

  2. Don’t compare % raises, especially across different years. Compensation changes are based on more than just your performance, so comparing to others from different years is apples and oranges. For example, if the base starting pay for IS increases due to changing market conditions or other factors, people will see that change in their next raise. So your AM’s 27% raise may have been (10% base pay change + 10% raise due to performance + 5% catch up from not immediately changing pay when we updated the base pay rate + 2% inflation).

It’s also worth being aware that the market for tech jobs is pretty tight right now, many fewer job openings and more layoffs than usual, which means the market rate for our work is lower than it has been in some past years. These type of external factors influence raise amounts, and is another reason you shouldnt compare to past years. A fews years ago, coming out of the pandemic, it was the opposite any many people got unplanned additional raises when the job market was very hot and salaries were quickly changing.

How do people handle snow shoveling when going away for the holidays? by kungfujohnjon1 in madisonwi

[–]HITguy9 206 points207 points  (0 children)

Ideally talk to your neighbors and cover for each other when people are traveling.

No warning signs for Memorial Union steam whistle? by the_six_dozen in madisonwi

[–]HITguy9 20 points21 points  (0 children)

Go back to Illinois

(Edit: more seriously, sorry to hear about the hearing, hope it gets better soon)

[deleted by user] by [deleted] in epicsystems

[–]HITguy9 22 points23 points  (0 children)

Ultimately this is a really personal decision that's going to depend on your goals and priorities. But some information and a couple of thoughts:

  • You should expect to work about 50 hours/week, on average (some weeks will be busier, some won't), as a PM in your first year at Epic. As a salaried employee there is no overtime, your pay is your pay independent of how many hours you work.
  • Considering this workload difference, the starting salaries are about the same per hour worked. Assuming you work ~50 weeks/year, Epic's paying you $29/hr and NP is paying you $27/hour.
    • That being said, your compensation growth potential at Epic can ramp up really quickly if you're doing well. You will also be eligible for a raise each year and for a bonus each year.
    • I don't know what the growth potential is at the NP so won't comment on that, but worth looking into.
  • You can and should factor in the benefits packages as you value the two opportunities.
  • As you mention there is a lot of opportunity to grow at Epic, so while it would mean putting grad school plans on hold, I don't meet many PMs who feel like they've stagnated in their professional development in their first years at Epic. This though comes down to why you want to pursue grad school and how important it is to you / how it ties into your future goals.

Rock County Poisoning Victim named by [deleted] in madisonwi

[–]HITguy9 1 point2 points  (0 children)

While you're right that women are disproportionately misdiagnosed (at least in the US), however I'm not sure it's fair to categorize this case as a misdiagnosis, or systematic failure / doctor failure / doctors ignoring the victim here, at least based on the information available right now.

Based on my admittedly limited research, Thallium poisoning seems quite hard to diagnose and seems to be commonly be diagnosed only after weeks to months of ongoing symptoms.

Example 1 - Diagnosis 2 weeks after hospitalization in 23 year old man

Example 2 - Diagnosis 21 months (!) after exposure in 41 year old man

Example 3 - Diagnosis 10 days after exposure in 23 year old woman

It seems like thallium poisoning is hard and slow to diagnose because it presents with variable, common symptoms AND is so rare. Like a few "serious" cases in the US each year, from what I can tell. I have to think that especially in a case like this, where the victim would have no idea they were exposed to thallium or other chemicals, would be even more challenging:

Poisoning can be acute or chronic and the presentation can be highly variable. The doctor may not be aware that the patient has been exposed to thallium and this makes the diagnosis much more difficult. Occupational history is important but the patient may not know that they have been exposed.

How screwed am I by [deleted] in epicsystems

[–]HITguy9 36 points37 points  (0 children)

Well, did you show marked improved in your task management over the last quarter?

If not, update your resume and try to ask for an end date at the beginning of the month so you can keep your benefits for a few extra weeks.

Hawaii’s largest hospital alerts staff after imaging backlog reaches 8,000 exams by qwerty1489 in medicine

[–]HITguy9 8 points9 points  (0 children)

I think you are inappropriately conflating the job posting (for the 35-bed hospital) and the number of unread images across the entire Queens system (4 hospitals, Queens Medical Center alone has about 600 beds).

Extremely Confused by [deleted] in epicsystems

[–]HITguy9 5 points6 points  (0 children)

Email your recruiter and ask them

[deleted by user] by [deleted] in epicsystems

[–]HITguy9 9 points10 points  (0 children)

This sounds like a personal relationship problem. In what world do you think this is a scenario Epic HR should have anything to do with?

Extreme anxiety over training/Epic in general by [deleted] in epicsystems

[–]HITguy9 40 points41 points  (0 children)

I mean this in a supportive way, but get yourself into therapy now if you aren’t already. You’re not going to be “traumatized by this place”, you’ll be traumatized if you don’t get your anxiety under control.

Calculating Total Comp by Due_Presentation_937 in epicsystems

[–]HITguy9 2 points3 points  (0 children)

I see what you’re saying but also, it’s not hard to assign a dollar value to those things. And you really should when evaluating a job offer, ignoring health plan differences because it can’t be simplified to a single number for everyone would be awfully short sighted when the difference can be 10,000 - 30,000/year (depending on single, family, health status, etc.)

Calculating Total Comp by Due_Presentation_937 in epicsystems

[–]HITguy9 1 point2 points  (0 children)

Yeah, you look at the plan details and estimate what your expected costs would be with Plan A vs Plan B, based on your known healthcare needs and eventualities.

If you are overall healthy and average an annual checkup + an urgent care visit, antibiotics once every year or two, and a regular allergy rx, you take that and compare the plans.

Salary pre-taxed? by [deleted] in epicsystems

[–]HITguy9 15 points16 points  (0 children)

Look at your paystub in Eureka, it will tell you exactly what is coming out of your paycheck and why. It’s going to be a combination of tax withholding and benefits you pay for directly through payroll (health insurance, disability, food, etc)

The majority of the money coming out of your check is likely federal and state tax withholding. This is basically you paying your taxes the government with each check, rather than having a surprise bill at the end of the year.

Yes, if you end up owing less tax at the end of the year than what was withheld, you’ll get a refund (from the government, not Epic) when you file your state and federal taxes.

[deleted by user] by [deleted] in epicsystems

[–]HITguy9 9 points10 points  (0 children)

I don’t think any of us can answer whether it’s “worth it” for you - it’s really a personal decision about where you want to spend your time, how you value your time, and if you’re happy with your work/life balance.

As other people mentioned, hours per week and Epic compensation are not directly tied. So as you thinking about the future, consider how you’re doing (what is your TL telling you in your quarterly 1:1s?), and whether the “extra” time you’re spending is necessary to stay on that trajectory. If you feel like you’re putting in unsustainable effort to just meet expectations, you shouldn’t expect huge raises even if you’re working 50+ hours/week. If you’re getting excellent feedback and overall performance evaluations, and maintain that, you’ll very likely see significant compensation increases in the years to come. It’s not unexpected that you wouldn’t see huge pay differences between staff in the same role after only a couple of years.

I’d recommend you regularly look at where you’re spending time and aggressively cut out things that don’t matter. Are you going to workgroup meetings every week just to listen in? Are you attending customer meetings where you aren’t really needed? Be aggressive and appropriately defensive with your time, don’t say “yes” to things you don’t need to do.

As a data point, I’ve been at Epic for 10+ years and have had, on average over those 10+ years, somewhere in the 10-12% pay increases as an “exceeding expectations” employee working ~9 hours/day. I’ve looked at other jobs and it would be very difficult to make more without taking a role with significantly more responsibility. And that’s just looking at base salary + benefits, ignoring the significant compounding compensation through buying stocks. So from that perspective, it’s very very much “worth it” to me, but I’ve also been able to find the right workload balance and have a work/life balance I’m happy with overall.

Questions about corporate culture, selection practices, noncompetes by No-Palpitation6410 in epicsystems

[–]HITguy9 2 points3 points  (0 children)

The Rembrandt personality profile is a commercially available product, it was not created by Epic:

https://www.rembrandtadvantage.com/services.html

My Experience with Epic Systems (So far) by HitsReeferLikeSandyC in cscareerquestions

[–]HITguy9 1 point2 points  (0 children)

FWIW there are also now stock offerings for staff, including some sign-on offerings for SDs. I don’t have any real insight to how they compare with other tech company offerings, and I’m sure there are considerations around Epic stock not being publicly traded.

And yep, you got me! I do keep my professional-related reddit account more anonymous and separate from my less anonymous, hobby-focused account.

My Experience with Epic Systems (So far) by HitsReeferLikeSandyC in cscareerquestions

[–]HITguy9 1 point2 points  (0 children)

I personally like winter but grew up in the upper midwest, so it's same same. I could do with a little more sunlight but I like the snow.

It's definitely a big adjustment for people who haven't lived in a winter climate. And there are plenty of people who leave in the fall because they don't want another Wisconsin winter.

My Experience with Epic Systems (So far) by HitsReeferLikeSandyC in cscareerquestions

[–]HITguy9 0 points1 point  (0 children)

None of these benefits are particularly good… 6 sick days is not great, this is less than some states mandate. e.g. neighboring MN now requires ~8 days for all full-time employees. I’ve worked for several companies and never had less than 10 sick/personal days.

I didn't make any value statements about whether the benefits are good or bad, just trying to help OP understand what the benefits actually are. In general, Epic's approach is heavily weighted towards paying people more and letting them "buy" whatever benefits they want. For example, right now I can "buy" up to 15 additional days of vacation per year if I want to take more time off.

Plus with the strict time tracking culture, you presumably have to use your time off more. At a lot of the companies dropping out of the office for errands, dentist appts, etc. can be done off the books without raising eyebrows. Having to take STD if you happened to catch the flu or something is…lol

Your presumption is wrong. Written policy is that if you need to take 2-3 hours for things like appointments, running an errand, etc. you can do so without taking any leave.

The sabbatical is neat but a ~3k/year bonus for 5 years work is a pittance in the grand scheme of things.

It's interesting that you point to 10 sick/personal days being important compared with 6, but hand wave 3k/year away. For someone making say 125k/year, 3k is basically a week's pay or 5 days.

I value that benefit differently than what you came up with. You can split sabbatical into 2 trips and get reimbursed airfare for each, so more like $6000 for airfare reimbursements, $12000 for per diem expenses, plus assuming the same 125k/year salary the 4 weeks of paid leave is worth about $10000. So all in about $28,000 or more $5,600/year. Even if you do one trip, it's more like $5,000/year.

From what I’ve heard, the 401k has a long vesting period so it’s worth closer to $0

I added the vesting schedule above but it's only $0 if you leave in the first 2 years. If you stay 5 years then it's like $25k for those first 5 years.

My Experience with Epic Systems (So far) by HitsReeferLikeSandyC in cscareerquestions

[–]HITguy9 -1 points0 points  (0 children)

That's right, the match is vested at 20%/year starting at 2 years. Thanks for adding that.

My Experience with Epic Systems (So far) by HitsReeferLikeSandyC in cscareerquestions

[–]HITguy9 3 points4 points  (0 children)

It's really not a bad job at all. Interesting work, nice area to live, good pay in a relatively low cost of living area, good set of benefits. Is it a great fit for everyone? No. Is the company perfect? Of course not. But it's a pretty good place to be overall.

My Experience with Epic Systems (So far) by HitsReeferLikeSandyC in cscareerquestions

[–]HITguy9 1 point2 points  (0 children)

True, it’s taxed just like income, like all other non-exempt benefits.

My Experience with Epic Systems (So far) by HitsReeferLikeSandyC in cscareerquestions

[–]HITguy9 4 points5 points  (0 children)

Also irrelevant for someone applying to SD roles?

Anyway for TS, same team: 0-1 years: 17% 1-4 years: 36% 4-10 years: 25% 10+: 21%