meryyjhon wrote on Monday, February 23, 2009:
Why so many doctors finding themselves focused on software these days? Why government, payers and market forces are all pushing doctors to consider an Electronic Medical Records (EMR) strategy?
ideaman911 wrote on Tuesday, February 24, 2009:
The short answer has to do with cost. Every keystroke which they don’t have to do is a savings in labor for them. Of course, it is an added cost for the Clinicians, but they have a lot of excess time on their hands, don’t they? There are other, more insidious, reasons also, which have to do with their ability to reject claims. When payers had to do the keying from 1500 forms, they didn’t bother with information which they had in their databases. Like the DOB for the parent of an actual patient, their employer, etc. Everything they needed to know was in the patient policy code and the verification of legitimacy was the DOB for the patient (yes, I know they insisted on SSN, which allowed identity theft, but they have had their hands slapped… Just not enough). So they ignored those fields and processed ONLY what was required to adjudicate the claim.
By shifting the cost of keying to the providers, they can firewall claims which do not have absolutely every piece of information which can be known about a patient, supposedly in the name of patient “protection”. That’s why they call those fails “HIPAA Related”.
But they also have the power of the leverage - you want the pictures of dead presidents they have, so they get to make the rules. Rail against them though we might, we either find a way to work with them or forget about eating soon. Ergo…
From the clinician’s standpoint, manual process requires some form of data entry, whether handwritten or keyed. But once YOUR computer has it, you need not key it again. In pure time value for money terms, you start to see a return on that investment only after the third visit. So surgeons are less well served than, for example, psychologists, assuming there are only a limited number of times they will cut into a typical patient 
Welcome to the world of industrial engineering. Get used to it.
Joe Holzer
I thin
cfapress wrote on Tuesday, February 24, 2009:
The benefit to EMR over a paper based office is mostly subjective. I’m just a programmer so I can’t point out any objective studies but I’m sure they are available.
For our Agency EMR makes sense. We operate 15+ school based health centers in southeastern Connecticut. Students pass in and out and in-between of the schools so their medical records need to be available from multiple locations. Also, the nurses travel from site to site and need access to records from remote locations. Having a web-based EMR system makes all of this trivial.
Plus, once we’re fully using EMR we can then generate comprehensive reports and historical data for our clients, the State, the Fed, and for our internal use. Try that with cabinets full of papers.
The transition to EMR is going to be slow and require redundant data entry. Not a pleasant process but we’ve got to do it as the benefits are crystal clear.
Jason
cverk wrote on Wednesday, October 06, 2010:
Groups such as Kaiser are posting better preventive care numbers for lower cost by relying heavily on EMR’s and physician extenders. The rest of us think we are practicing quality care, but without moving towards EMR’s we cannot prove that, and we cannot really compete.