Category Quotation Less interaction with colleagues "... it's like being in a steno poolwhere you walk in (to the physician team office) and everybody'styping; there's no actual communication going on, no interaction withanybody else." "I definitely notice we spend lesstime with the nurses (since the transition to CPD)... we're missingthat 'by the way' interaction that we had before." "There's none of the socialization happening at the nurses station where people come and talk to one another." Less time with patients "... and now (the information) is like all gathered and you don't sit with the patient as much." More time in documenting "We're definitely spending more time in the hospital, especially if you're a bad typist." More time in office "The immediate thing I notice is thatdoctors are now confined to their offices for a huge amount of theirtime... I don't know if that's good or bad; it's just different, andit's made the wards seem like a different place. There's a differentmilieu up there in general." Documenting at different times "Because you can only do it whenyou're sitting right there, ... you can't write little bits of yournote on the fly like we used to. I suppose you could log into acomputer somewhere else (to complete it), but it's just too much of ahassle; logging in, logging out, logging in." Documenting at different locations "I remember having my piece of paperand my clipboard, filling in my H&P and talking to the patient atthe same time, and getting my information and establishing a rapport,..." Less dictation, more typing "I think the dictated note has muchbetter flow and amount of content and actually pertinence ofinformation is better that way, too, because you actually have to thinkabout what you're saying. The problem with typed notes, is that eitherthere's not as much information that goes into it, and you leave stuffout, or they automatically put in vast reams of information that areirrelevant." "I saw this specifically with thisnew group of interns, where since nobody's ever taught them how to do adischarge summary, they feel uncomfortable doing it; it's too muchwork. It's easier for them to cut-and-paste and type, and have theirnote be done and gone, and not have to worry about it, than to take thetime to figure out how to dictate a true discharge summary."