sunsetsystems wrote on Tuesday, November 26, 2013:
Thought I’d pass this on – my MD sister sent me this link. If you’re not already a medscape.com subscriber, it’s a simple free process to sign up.
It ends with:
Hanover said EHR vendors have their work cut out for them in boosting the number of happy customers. “Bells and whistles really don’t matter,” she said. “Vendors are failing on the basics.”
fsgl wrote on Tuesday, November 26, 2013:
For most of us, pen and paper is still the fastest way to enter a H & P. This is especially true for drawing a clinical finding.
Andy Grove was correct when he said that the computer should be as intuitive and easy to use as the telephone.
The real question is how the medical community will react when HITECH’s sticks start to sting.
A quote from the Wikipedia page on HITECH:
"The National Coordinator for Health Information Technology, Dr. Farzad Mostashari, has explained: “You need information to be able to do population health management. You can serve an individual quite well; you can deliver excellent customer service if you wait for someone to walk through the door and then you go and pull their chart. What you can’t do with paper charts is ask the question, ‘Who didn’t walk in the door?’”
I thought that was one of the functions of the appointment book binder.
Dr. Mostashari’s video interview.
He would have been less sanguine about EHR adoption rates, had he the benefit of knowing the Meaningful Use Attestation rates between 2011 and 2012. See this thread.
mike-h30 wrote on Thursday, December 05, 2013:
http://www.macgasm.net/2013/12/05/ipads-ottawa-hospital-apple/
…the Ottawa Hospital became the first hospital in the world, to place an electronic order (CPOE) from a native iPad app on March 27th, 2012. The pilot program’s initial problem was solved: physicians were now using CPOE and doing it at an astonishing rate.
fsgl wrote on Thursday, December 05, 2013:
I spoke to a Family Practice colleague yesterday who started using Allscripts’ EHR one year ago. She is still devoting 2 hours extra, every day, because of the increased workload created by the transition.
cmswest wrote on Friday, December 06, 2013:
i’m wondering if she is now into stage 2 mu, “advance clinical processes”?
http://www.healthit.gov/policy-researchers-implementers/meaningful-use
here in vermont, it is going to be onerous to satisfy the reporting for the newly formed aco, onecare, which has additional measures beyond stage 2 that must be satisfied; i’m afraid if your emr is not able to report out on a myriad of measures to a docsite registry or vt trademark “blueprint” interface then you are forced to enter data through saas modules which will not be pleasant to a perhaps already overburdened staff
thankfully Rod Roark is going to help build an interface from openemr to the vermont health information exchange, vhie see http://vitl.net/specifications, by starting with lab results and hopefully we’ll be able to progress toward other clinical interfaces
someday all of this code will be returned to the community to hopefully further connectivity work with other hies
fsgl wrote on Friday, December 06, 2013:
There is no question that Meaningful Use at any stage adds to the burden. Most physicians view the EHR Bonus as not worth the trouble and Meaningful Use Requirements as a downright nuisance (I am thinking about Jack Cahn’s remark in the above cited thread).
In my own practice, supplying patients with a clinical summary is non-productive work. My patients come in with a list of their medications, prescribed by their Internists, and by inference I would know the non-Ophthalmic history. I would then dutifully copy their list and regurgitate it back to the patients via the clinical summary. Thus far, patients have been polite enough not to ask why they are given a copy of their own list.
Back in the late 1980’s when it became clear that claim submission and accounts receivable could no longer continue manually, we gathered the funds and invested in a Practice Management software. The backlog resolved quickly and we were pleased with the investment. No one had to give us a bonus to become more efficient. Unfortunately, folks like Dr. Mostashari are not in the trenches caring for patients, don’t know our work environment as well as we do and how best to care for our patients. If that is not the case, it’s not obvious from the video.