EMR's have been a disaster for clinicians. As a patient, I like the patient portal, where I can get and receive messages, cancel appointments, get lab tests, etc. But doctors are reduced to data input clerks, become much less efficient, and as some say, have their souls sucked out of them. Here is a brilliant exposition:
https://www.facebook.com/10000 1707018713/posts/2411531452247 065?s=1160393503&sfns=mo
It is such a violation that the decision makers for purchasing these things, the government and the administrators, victimize the doctors by their own ignorance and lack of advocacy for the doctors, and for the entire system of medicine, if truth be told.
This has been known for some time, but there is no sign of improvement. We're stuck. Government is doing nothing. Judith Faulkner, owner of Epic, remains a billionaire who obliviously observes, "Why would a patient want his medical record?" And Epic then produces records that no one can really use well, neither patients nor doctors. But they are good for billing!
Others say that doctors are just too stupid to use the EMRs correctly. Right.
Medical care is becoming like the weather, everyone complains about it but no one does anything about it. To me, the answer is strict government regulation of anti-trust measures, and vigorous pursuit of interoperative EMRs, regulating Epic and others as platforms, mandating that innovations from other companies be open for incorporation into them.
In medicine, corporatism is failing, as it has in so many other walks of life, because government has failed to regulate the marketplace so that competition is strong and works in favor of the consumer.
Just to make the feelings of doctors vivid, here are two trenchant comments from the American Academy of Pediatrics, Section on Administration and Practice Management Listserve:
I could not agree more. While I did not grow up with computers, I was
an early adopted of the Mac platform in 1986 when the 9” mac cost more
than $3000 and had a 20 megabyte hard drive and floppy disc! I used to
love the Mac until, in recent years, it began
to copy Microsoft in being packed with “features” that the average user
did not comprehend or need. It is still the best around, but getting
harder and harder to use.
HL, M.D.
https://www.facebook.com/10000
It is such a violation that the decision makers for purchasing these things, the government and the administrators, victimize the doctors by their own ignorance and lack of advocacy for the doctors, and for the entire system of medicine, if truth be told.
This has been known for some time, but there is no sign of improvement. We're stuck. Government is doing nothing. Judith Faulkner, owner of Epic, remains a billionaire who obliviously observes, "Why would a patient want his medical record?" And Epic then produces records that no one can really use well, neither patients nor doctors. But they are good for billing!
Others say that doctors are just too stupid to use the EMRs correctly. Right.
Medical care is becoming like the weather, everyone complains about it but no one does anything about it. To me, the answer is strict government regulation of anti-trust measures, and vigorous pursuit of interoperative EMRs, regulating Epic and others as platforms, mandating that innovations from other companies be open for incorporation into them.
In medicine, corporatism is failing, as it has in so many other walks of life, because government has failed to regulate the marketplace so that competition is strong and works in favor of the consumer.
Just to make the feelings of doctors vivid, here are two trenchant comments from the American Academy of Pediatrics, Section on Administration and Practice Management Listserve:
Oh,
man, he is singing my tune! (referring to the ZDog clip that started this post.) I literally grew up with computers dating
back to the Commodore 64 and Vic 20. I learned to program as an
elementary and middle school child and was always very pro technology. I
was an early adopter of the palm pilot and handspring devices because
they were innovating and creating new and more efficient ways to care
for patients. I used a Palm device to do my progress notes in residency
and was able to do so efficiently. At that point, the technology
increased my efficiency and organization, so I used it.
I
finished residency and spent the first 11 years of my career on paper
and was rather efficient. I saw roughly 6000 patients a year and then
transitioned to electronic records.
After
four years on Centricity, I can only see about 4000 patients a year
while working longer hours. Additionally, the quality of what I am
doing for my patients is worse than what I was able to provide when I
was on paper. Among other things, this is why I am finally setting out
into independent practice. At least I can choose my EHR this way.
All
this to say that we could keep virtually every benefit of electronic
records and regain quality and efficiency if we could return to paper
for almost everything except a problem list, allergies and medications.
Perhaps in the hospital you might want to include a few other features,
but undoubtedly you could make the system much more efficient and
improve quality of care by eliminating most of what has to be done in
the computer.
My two cents,
DS, M.D.
|
I too could see 6000-7000 patients yearly on paper. Now, 4000 is a
stretch and it is solely due to the adoption of the word vomit
producing, time sucking, soul killing nearly useless EMR, also with much
longer hours needed to be a click monkey.
The only useful part is ERx and allergies and legibility. All
other “improvements” in data collection, population health, and better
care have been total vaporware.
Thank the government for essentially mandating the adoption of
mutually incompatible, horrible programs for all, without any effort at
producing a universal standard or insisting on user friendliness.
IMHO it has been a total disaster. Longer hours, no eye contact,
box checking instead of history taking, choices limited by databases,
not by what you need and the total loss of ability of the clinician to
find any useful nuggets of data amid
the pages and pages of word vomit spewed forth by EMR.
And that was me being polite.
HL, M.D.
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