October 06, 2008
EMR implementation -- a saving grace or year of hell?
By Shahid Shah
A friend of mine sent me this link - "Beware of the EMR ‘Ponzi scheme,’ warns physician leader" — earlier this week. The article starts off by saying:
Healthcare IT does not necessarily make life easier for
primary care physicians, says a leader in the movement to make medicine
more efficient and patient-centered.
"When you put an EMR into a primary care practice, your life is hell for the next year," said L.Gordon Moore, MD.
"EMR vendors aren’t really giving us what we need. We have to make a
distinction between a robust EMR with decision support tools, and one
that is just being marketed as a way to improve coding. And we really
need to get out of the E&M coding game."
Yikes. I’ve been in the health care IT market for a while and that’s
probably one of the strongest anti-EMR statements I’ve seen publicly.
I know many readers are physicians — how many of you concur with Dr. Moore?
Shahid Shah is a health care consultant, specializing in IT. He blogs regularly at The Healthcare IT Guy.
October 6, 2008 in Electronic Medical Records, Physicians, Technology | Permalink
Comments
That's been our experience. We haven't been using it for a full two months yet, but it has slowed us down immensely (or at least you can see the same number of patient in a day, if you are willing to dedicate another 10-20 hours per WEEK to documentation) and it doesn't offer much beyond coding. Hell, it doesn't even really support coding all that well ... there's no way to glance at the day's list of patients to see that you've submitted the charges and generated the damn "reports". At least with my paper billing sheets, even though I charged more 99213s, I could tell when I was done with the chart. We give cash patients a 15% discount, if they pay at the time of service, but we still haven't figured out how to do that through the new tools.
Decision tools? The EMR we bought barely supports keeping track of health maintenance issues like mammograms and colonoscopy. (It keeps reminding me that people whose colos I have patiently entered -- and it does require patience to enter a damn date -- haven't had flex sigs.) I can't easily leaf back through previous visits' progress notes! The drug contraindication warnings are repetitious and a joke. It warns me to be careful prescribing sumatriptan for people with the diagnosis "migraine" and metformin for people with the diagnosis "diabetes". It throws up the same strings of warnings twice for each drug I enter. You can bet that I consider those warnings carefully as I irritably bash the "acknowledge" key repeatedly.
I was a software engineer for 10 years before I went to medical school. I'm not a luddite and I can quite clearly see the useful potential for software to support physicians, but the EMRs and near EMRs that I've worked with do little to help and much to hinder.
Posted by: J Bean | Oct 6, 2008 9:28:20 AM
My company is doing something that may be of interest to this group. We're hosting a town hall meeting about healthcare reform and electronic health records. The meeting is scheduled for Dec. 1 at Seattle's Town Hall. For more information go to healthcaretownhall.com.
Posted by: Jessie A. | Nov 18, 2008 8:26:23 PM
I firmly believe as the gentleman has stated above. Current versions of EMR's ar awkward, diorganized, difficult to use and unsuitable for practice as we have it today. Its really not surprising, medical information have defied computerization for the last 20 years. It's very likly that the right system hasn't even been examined yet.
Problems that the current systems tend fail on are rational, organized physician entry and recovery (the idea of the system is to unload the menial burdens from the physician can do what he is trained for. Data storage in a flexible secure way is another problem. The standardized billing form presents the requirements of data from the patient, the payor, insurance companies, problems, procedures, codes and costs and there are many possible relations to each field.
I mention the billing not to say that printing a clean billing form is a priority but to emphasize that the data is extremely complex. I want a system that will make it impossible for me to make a mistake whether it is from miskeying aor lack of knowledge. I want to know drugs of choice. I want a program that can look back in the problem list and note a potentially related problem from earlier.
We're talking about trillions of dollars of saving with a development effort probably in the low millions if that. We're also talking about a goverment that wastes 3 billion dollars that can be out performed by 1995 technology.
Hello.....! is anyone listening?
Posted by: Greg Starr MD | Sep 5, 2009 10:38:18 PM
Check this out!!!!
Posted by: Patrick Case | Sep 28, 2009 9:14:04 PM
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