So LEI is still using paper charts (pictured above), which is not at all surprising given the limited number of computers on site and the spotty electrical grid. Most patients keep/maintain their own medical record and are very reliable about bringing notes from previous hospitalizations, clinic visits, etc. It’s very impressive! It’s also very funny to see the reactions I get when I tell people that most hospitals in the U.S. have completely done away with paper charts in favor of electronic records. “WHY???” they exclaim. I go through the various reasons as I understand them – patient safety, efficiency in communication between doctors, billing. But our system is so vastly different compared to how things operate here that none of what I describe really seems to make sense. Take billing, for example – all patients at LEI pay up front for any services they receive. Everyone arriving for a clinic visit with the cornea specialist comes with a receipt of payment for fifty Nepalese Rupees (about 60 cents). A corneal swab for culture at the microbiology lab runs 200 NPR ($2.35). I bought a Coke today after work for the same price as a doctor’s visit. Fascinating.
Otherwise, I’m making steady progress on the research front and collecting some awesome anterior segment photos. I also had the opportunity to spend a few mornings in the operating “theater” last week, first observing and then performing some of the steps of small incision cataract surgery. The number of cases LEI’s surgeons turn out with this technique is truly amazing. On Friday, four doctors performed a total of 100 cataract surgeries in under four hours. In a full day, the same number of staff can do up to 300 cases. Jaw-dropping. Tomorrow I plan to observe a few strabismus (“squint”) operations. All in all, shaping up to be a very well-rounded experience!