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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
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