Comments on: Why doctors are reluctant to adopt electronic records http://www.kevinmd.com/blog/2009/01/why-doctors-are-reluctant-to-adopt.html medical blog Sun, 22 Nov 2009 19:59:44 -0500 http://wordpress.org/?v=2.8.4 hourly 1 By: Manalive http://www.kevinmd.com/blog/2009/01/why-doctors-are-reluctant-to-adopt.html/comment-page-1#comment-89020 Manalive Sat, 03 Jan 2009 21:22:00 +0000 http://clients.emmense.com/kevinmd/2009/01/why-doctors-are-reluctant-to-adopt-electronic-records.html#comment-89020 Van: Thank you! The problem is not due to lack of consistency between providers who use EMRs. Friends of mine in various specialties deplore them. EMRs are always off target, especially in primary care: they're too narrow when the doc needs to be broad, and too broad when the doc needs to narrow.<br/>The ER's EMR is the worst: designed to "capture billables" and also designed to deflect legal liability, ER EMR reports go on at great length about nullities: Nurse Murphy signed out the case to nurse Jones at 15:42 -- who signed the case back over to Nurse Murphy again at 17:03, etc, etc. The economists would describe it as a misallocation of resources.<br/>It can be difficult to tease out of a five page ER report the simple truth that Mr. Smith went to the ER with renal colic; that the IVP showed a 3mm stone; and that he was sent home with narcotics.<br/>Finally, any parent of a teenager knows why patients dislike EMRs. Any important conversation with a teenager -- such as the meaning of life, or why the Dodgers ought to bunt -- is sure to be interrupted by a text message. "Of course I'm still listening" she says as she types furiously on her phone. Van: Thank you! The problem is not due to lack of consistency between providers who use EMRs. Friends of mine in various specialties deplore them. EMRs are always off target, especially in primary care: they’re too narrow when the doc needs to be broad, and too broad when the doc needs to narrow.
The ER’s EMR is the worst: designed to “capture billables” and also designed to deflect legal liability, ER EMR reports go on at great length about nullities: Nurse Murphy signed out the case to nurse Jones at 15:42 — who signed the case back over to Nurse Murphy again at 17:03, etc, etc. The economists would describe it as a misallocation of resources.
It can be difficult to tease out of a five page ER report the simple truth that Mr. Smith went to the ER with renal colic; that the IVP showed a 3mm stone; and that he was sent home with narcotics.
Finally, any parent of a teenager knows why patients dislike EMRs. Any important conversation with a teenager — such as the meaning of life, or why the Dodgers ought to bunt — is sure to be interrupted by a text message. “Of course I’m still listening” she says as she types furiously on her phone.

]]> By: Van http://www.kevinmd.com/blog/2009/01/why-doctors-are-reluctant-to-adopt.html/comment-page-1#comment-89014 Van Sat, 03 Jan 2009 14:15:00 +0000 http://clients.emmense.com/kevinmd/2009/01/why-doctors-are-reluctant-to-adopt-electronic-records.html#comment-89014 @manalive<br/><br/>Thanks for the reply.<br/><br/>Do you think that there is any way to address these issues? That is to say, are these issues due to a lack of consistency between providers who use EMRs?<br/><br/>Also, what makes your patients unhappy about EMRs? Is it a time issues? Quality issue?<br/><br/>All the best,<br/>Van<br/><br/><a HREF="http://vansantos.com" REL="nofollow">http://vansantos.com</a> @manalive

Thanks for the reply.

Do you think that there is any way to address these issues? That is to say, are these issues due to a lack of consistency between providers who use EMRs?

Also, what makes your patients unhappy about EMRs? Is it a time issues? Quality issue?

All the best,
Van

http://vansantos.com

]]> By: Anonymous http://www.kevinmd.com/blog/2009/01/why-doctors-are-reluctant-to-adopt.html/comment-page-1#comment-89007 Anonymous Sat, 03 Jan 2009 03:29:00 +0000 http://clients.emmense.com/kevinmd/2009/01/why-doctors-are-reluctant-to-adopt-electronic-records.html#comment-89007 when our hospital adopted EMR for the ER, productivity decreased 25% and waits increased over 50%. Although it increased revenue per patient overall revenue declined. This was supposedly one of the best EMR's but two years later and things have not imporved. Patient and doctor satisfaction has declined.<br/><br/>Our EM group staffs many ER's and those for those on the cusp of retirement instillation of an EMR is the last straw to put the nail in the coffin. when our hospital adopted EMR for the ER, productivity decreased 25% and waits increased over 50%. Although it increased revenue per patient overall revenue declined. This was supposedly one of the best EMR’s but two years later and things have not imporved. Patient and doctor satisfaction has declined.

Our EM group staffs many ER’s and those for those on the cusp of retirement instillation of an EMR is the last straw to put the nail in the coffin.

]]> By: Manalive http://www.kevinmd.com/blog/2009/01/why-doctors-are-reluctant-to-adopt.html/comment-page-1#comment-89001 Manalive Fri, 02 Jan 2009 22:44:00 +0000 http://clients.emmense.com/kevinmd/2009/01/why-doctors-are-reluctant-to-adopt-electronic-records.html#comment-89001 Van: 1)They're terribly inefficient for the using doctor. 2)The programs I've seen detract from -- not enhance -- communication among providers.3)My patients are often unhappy when they consult a doctor who uses them.4)Insurance companies intend to use them to screw my patients. Van: 1)They’re terribly inefficient for the using doctor. 2)The programs I’ve seen detract from — not enhance — communication among providers.3)My patients are often unhappy when they consult a doctor who uses them.4)Insurance companies intend to use them to screw my patients.

]]> By: Van http://www.kevinmd.com/blog/2009/01/why-doctors-are-reluctant-to-adopt.html/comment-page-1#comment-88996 Van Fri, 02 Jan 2009 17:48:00 +0000 http://clients.emmense.com/kevinmd/2009/01/why-doctors-are-reluctant-to-adopt-electronic-records.html#comment-88996 @manalive<br/><br/>Why are they an imposition?<br/><br/>Best,<br/>V<br/><a HREF="http://vansantos.com" REL="nofollow">http://vansantos.com</a> @manalive

Why are they an imposition?

Best,
V
http://vansantos.com

]]> By: Anonymous http://www.kevinmd.com/blog/2009/01/why-doctors-are-reluctant-to-adopt.html/comment-page-1#comment-88992 Anonymous Fri, 02 Jan 2009 14:46:00 +0000 http://clients.emmense.com/kevinmd/2009/01/why-doctors-are-reluctant-to-adopt-electronic-records.html#comment-88992 I have heard that electronic records will give you the data necessary to rank and rate doctors and this is the reason why they won't switch over to electronic records. They don't want to be under scrutiny. I have heard that electronic records will give you the data necessary to rank and rate doctors and this is the reason why they won’t switch over to electronic records. They don’t want to be under scrutiny.

]]> By: healthitgirl http://www.kevinmd.com/blog/2009/01/why-doctors-are-reluctant-to-adopt.html/comment-page-1#comment-88991 healthitgirl Fri, 02 Jan 2009 13:50:00 +0000 http://clients.emmense.com/kevinmd/2009/01/why-doctors-are-reluctant-to-adopt-electronic-records.html#comment-88991 Another problem with existing EMRs is that they were developed for hospitals to capture charges. They were not designed for doctors to document patient care; as such many are cumbersome to use and lose the richness of text that comes from dictation. Another problem with existing EMRs is that they were developed for hospitals to capture charges. They were not designed for doctors to document patient care; as such many are cumbersome to use and lose the richness of text that comes from dictation.

]]> By: Manalive http://www.kevinmd.com/blog/2009/01/why-doctors-are-reluctant-to-adopt.html/comment-page-1#comment-88989 Manalive Fri, 02 Jan 2009 10:41:00 +0000 http://clients.emmense.com/kevinmd/2009/01/why-doctors-are-reluctant-to-adopt-electronic-records.html#comment-88989 EMRs are an imposition at any price.<br/>New HHS Sec. Tom Daschle is hell-bent to force this tyranny on us --and our patients. EMRs are an imposition at any price.
New HHS Sec. Tom Daschle is hell-bent to force this tyranny on us –and our patients.

]]> By: Van http://www.kevinmd.com/blog/2009/01/why-doctors-are-reluctant-to-adopt.html/comment-page-1#comment-88988 Van Fri, 02 Jan 2009 07:55:00 +0000 http://clients.emmense.com/kevinmd/2009/01/why-doctors-are-reluctant-to-adopt-electronic-records.html#comment-88988 Of course the issue comes down to cost - we have to remember that most Doctors who have small practices don't have huge chunks of money set for IT.<br/><br/>Also, as Michelle Greer pointed out, there is no standard for EMRs, and the only way one will truly be established is if the government mandates what would be used.<br/><br/>V<br/><a HREF="http://vansantos.com" REL="nofollow">http://vansantos.com</a> Of course the issue comes down to cost – we have to remember that most Doctors who have small practices don’t have huge chunks of money set for IT.

Also, as Michelle Greer pointed out, there is no standard for EMRs, and the only way one will truly be established is if the government mandates what would be used.

V
http://vansantos.com

]]> By: Michelle Greer http://www.kevinmd.com/blog/2009/01/why-doctors-are-reluctant-to-adopt.html/comment-page-1#comment-88987 Michelle Greer Fri, 02 Jan 2009 04:14:00 +0000 http://clients.emmense.com/kevinmd/2009/01/why-doctors-are-reluctant-to-adopt-electronic-records.html#comment-88987 It seems like there are many technologies available but no de facto standard. I saw a presentation on healthcare 2.0 from Microsoft at SxSW Interactive, but many of the people present were hesitant to keep them in charge. Without one standard like Microsoft Office, keeping people up to date on technology would be incredibly difficult.<br/><br/>Bear in mind, I would hate to see the standard be Microsoft, but it seems like there should be something all doctors use. It seems like there are many technologies available but no de facto standard. I saw a presentation on healthcare 2.0 from Microsoft at SxSW Interactive, but many of the people present were hesitant to keep them in charge. Without one standard like Microsoft Office, keeping people up to date on technology would be incredibly difficult.

Bear in mind, I would hate to see the standard be Microsoft, but it seems like there should be something all doctors use.

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