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	<title>Comments on: Skin in the game for electronic records</title>
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		<title>By: Anonymous</title>
		<link>http://www.kevinmd.com/blog/2008/04/skin-in-game-for-electronic-records.html/comment-page-1#comment-85100</link>
		<dc:creator>Anonymous</dc:creator>
		<pubDate>Sat, 19 Apr 2008 00:03:00 +0000</pubDate>
		<guid isPermaLink="false">http://clients.emmense.com/kevinmd/2008/04/skin-in-the-game-for-electronic-records.html#comment-85100</guid>
		<description>&quot;No physician in their right mind is going to willingly fork out 20-50 grand for some poorly designed software that makes their life more difficult and makes it easier for these parasites to suck their blood.&quot;&lt;br/&gt;&lt;br/&gt;And if they have any sense they will be even less willing to accept a gift from those same bloodsuckers of software that will give the parasites even more control over their every move.  There is, never was, and never will be any  such thing as a free lunch.  &lt;br/&gt;&lt;br/&gt;The only EMR that is going to make doctors work easier is one that is created by or for doctors to meet their needs and those of others--and as the payor calls the piper&#039;s tune, that will only be true of the record that doctors are paying for but are doing so gladly and of free choice because it is worth it to them.  &lt;br/&gt;&lt;br/&gt;My practice brochure includes a statement that the medical record in my practice  is created for the purpose of optimizing medical care--and is not necessarily suitable for establishing disability, contesting insurance claims, supporting litigation, or the various other non-cliinical purposes to which records are sometimes put.</description>
		<content:encoded><![CDATA[<p>&#8220;No physician in their right mind is going to willingly fork out 20-50 grand for some poorly designed software that makes their life more difficult and makes it easier for these parasites to suck their blood.&#8221;</p>
<p>And if they have any sense they will be even less willing to accept a gift from those same bloodsuckers of software that will give the parasites even more control over their every move.  There is, never was, and never will be any  such thing as a free lunch.  </p>
<p>The only EMR that is going to make doctors work easier is one that is created by or for doctors to meet their needs and those of others&#8211;and as the payor calls the piper&#8217;s tune, that will only be true of the record that doctors are paying for but are doing so gladly and of free choice because it is worth it to them.  </p>
<p>My practice brochure includes a statement that the medical record in my practice  is created for the purpose of optimizing medical care&#8211;and is not necessarily suitable for establishing disability, contesting insurance claims, supporting litigation, or the various other non-cliinical purposes to which records are sometimes put.</p>
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		<title>By: drsam</title>
		<link>http://www.kevinmd.com/blog/2008/04/skin-in-game-for-electronic-records.html/comment-page-1#comment-85084</link>
		<dc:creator>drsam</dc:creator>
		<pubDate>Fri, 18 Apr 2008 14:38:00 +0000</pubDate>
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		<description>I agree with you Kevin.&lt;br/&gt;&lt;br/&gt;The typical EMR is massively expensive to implement.  The hardware is typically not too bad, but most of the software packages are just tremendously over-priced.&lt;br/&gt;&lt;br/&gt;In order for any physician to consider going EMR, he/she will want to see some advantage either to the patient in the form of better medical care, or to the physician himself/herself in the form of easier work, increaed productivity, or financial gain.&lt;br/&gt;&lt;br/&gt;Most docs when doing this little mental cost-benefit game just don&#039;t see the benefits of EMR outweighing the costs, particularly with many (most) of the software packages that actually seem to decrease the physicians quality of life and productivity and don&#039;t really offer any appreciable benefit to patients.&lt;br/&gt;&lt;br/&gt;It seems to me that the main beneficiaries of EMRs are in fact the same parasites who have already wreaked so much havoc with our health care system, i.e. the pharmaceutical industry, third party payers, plaintiff&#039;s attorneys, etc., as the EMR makes for easier data-mining and eliminates illegible handwriting.&lt;br/&gt;&lt;br/&gt;No physician in their right mind is going to willingly fork out 20-50 grand for some poorly designed software that makes their life more difficult and makes it easier for these parasites to suck their blood. &lt;br/&gt;&lt;br/&gt;The whole concept of medical records (both paper and electronic) has been completely bastardized by these parasites.&lt;br/&gt;&lt;br/&gt;The original intent of a medical record was to record information so that the next time the doctor saw the patient they would not have to rely on their memory to know what was seen and done, and so that if another doctor saw the patient, they could easily see what was seen and done previously by the original doctor.&lt;br/&gt;&lt;br/&gt;Medical records were never originally intended to exist for the purpose of documentation to satisfy third party payers or to provide evidence for lawsuits.&lt;br/&gt;&lt;br/&gt;Every EMR I&#039;ve seen has been designed around these bastardised purposes and as a result they tend to be unweildy to use and produce a patient record that is fairly worthless in regard of recording information that is useful to the physician.&lt;br/&gt;&lt;br/&gt;Personally, I&#039;m not some old anti-technology curmudgeon.  I think using computers to store information and automate tasks etc is a great idea and I&#039;m all for using EMR&#039;s in principle.  I just don&#039;t have any desire to fork out the mega-bucks required for most of the software packages I&#039;ve seen (and not been too impressed with).&lt;br/&gt;&lt;br/&gt;Take the aforementioned parasites out of the picture, and I suspect you&#039;d see most physicians gladly embracing EMR&#039;s, though without the need to get all the proper bullet points for a 99214 level visit, I suspect most docs would simply record their notes with a simple dictation service and word-processor software.&lt;br/&gt;&lt;br/&gt;The real advantage of the computers in medicine would be in generating reminders of needed health maintenance, watching for dangerous drug interactions, etc.&lt;br/&gt;&lt;br/&gt;Software to accomplish these tasks would be pretty simple to implement, and in fact already exists.</description>
		<content:encoded><![CDATA[<p>I agree with you Kevin.</p>
<p>The typical EMR is massively expensive to implement.  The hardware is typically not too bad, but most of the software packages are just tremendously over-priced.</p>
<p>In order for any physician to consider going EMR, he/she will want to see some advantage either to the patient in the form of better medical care, or to the physician himself/herself in the form of easier work, increaed productivity, or financial gain.</p>
<p>Most docs when doing this little mental cost-benefit game just don&#8217;t see the benefits of EMR outweighing the costs, particularly with many (most) of the software packages that actually seem to decrease the physicians quality of life and productivity and don&#8217;t really offer any appreciable benefit to patients.</p>
<p>It seems to me that the main beneficiaries of EMRs are in fact the same parasites who have already wreaked so much havoc with our health care system, i.e. the pharmaceutical industry, third party payers, plaintiff&#8217;s attorneys, etc., as the EMR makes for easier data-mining and eliminates illegible handwriting.</p>
<p>No physician in their right mind is going to willingly fork out 20-50 grand for some poorly designed software that makes their life more difficult and makes it easier for these parasites to suck their blood. </p>
<p>The whole concept of medical records (both paper and electronic) has been completely bastardized by these parasites.</p>
<p>The original intent of a medical record was to record information so that the next time the doctor saw the patient they would not have to rely on their memory to know what was seen and done, and so that if another doctor saw the patient, they could easily see what was seen and done previously by the original doctor.</p>
<p>Medical records were never originally intended to exist for the purpose of documentation to satisfy third party payers or to provide evidence for lawsuits.</p>
<p>Every EMR I&#8217;ve seen has been designed around these bastardised purposes and as a result they tend to be unweildy to use and produce a patient record that is fairly worthless in regard of recording information that is useful to the physician.</p>
<p>Personally, I&#8217;m not some old anti-technology curmudgeon.  I think using computers to store information and automate tasks etc is a great idea and I&#8217;m all for using EMR&#8217;s in principle.  I just don&#8217;t have any desire to fork out the mega-bucks required for most of the software packages I&#8217;ve seen (and not been too impressed with).</p>
<p>Take the aforementioned parasites out of the picture, and I suspect you&#8217;d see most physicians gladly embracing EMR&#8217;s, though without the need to get all the proper bullet points for a 99214 level visit, I suspect most docs would simply record their notes with a simple dictation service and word-processor software.</p>
<p>The real advantage of the computers in medicine would be in generating reminders of needed health maintenance, watching for dangerous drug interactions, etc.</p>
<p>Software to accomplish these tasks would be pretty simple to implement, and in fact already exists.</p>
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