Comments on: Why electronic medical records won’t improve patient care or cut costs http://www.kevinmd.com/blog/2009/12/electronic-medical-records-improve-patient-care-cut-costs.html Wed, 15 Feb 2012 00:27:00 +0000 hourly 1 By: bobhttp://www.kevinmd.com/blog/2009/12/electronic-medical-records-improve-patient-care-cut-costs.html#comment-121150 bob Sat, 05 Dec 2009 19:46:23 +0000 http://www.kevinmd.com/blog/?p=41459#comment-121150 Boy it feels great to know I'm not the only doc. who got stiffed with an EMR. It slows me down big time and detracts from the quality of my interaction with patients. I have wanted an EMR for 15 years and I like computers but the reality is not like the dream. It is more like a nightmare. I think you hit the nail on the head with the part about the user interface. If I could just roll my curser over the hypertext or module icon that I want and have it expand the way it does on a modern web browser I might actually come to enjoy my work again. Boy it feels great to know I’m not the only doc. who got stiffed with an EMR. It slows me down big time and detracts from the quality of my interaction with patients. I have wanted an EMR for 15 years and I like computers but the reality is not like the dream. It is more like a nightmare. I think you hit the nail on the head with the part about the user interface. If I could just roll my curser over the hypertext or module icon that I want and have it expand the way it does on a modern web browser I might actually come to enjoy my work again.

]]> By: Kishorehttp://www.kevinmd.com/blog/2009/12/electronic-medical-records-improve-patient-care-cut-costs.html#comment-121144 Kishore Sat, 05 Dec 2009 18:17:57 +0000 http://www.kevinmd.com/blog/?p=41459#comment-121144 gjudd, I think you're right. We've been debating different things. I think I've been coming off like I'm in favor of poorly designed EMRs, which I'm not. I mostly just took exception to the title of this post, "Why electronic medical records won't improve patient care or cut costs," when I think they have the potential to do these things, though I agree they're not being implemented correctly.It seems like the user interface needs some work, but I still think the potential is there with data aggregation and statistical study of this data, etc. gjudd, I think you’re right. We’ve been debating different things. I think I’ve been coming off like I’m in favor of poorly designed EMRs, which I’m not. I mostly just took exception to the title of this post, “Why electronic medical records won’t improve patient care or cut costs,” when I think they have the potential to do these things, though I agree they’re not being implemented correctly.

It seems like the user interface needs some work, but I still think the potential is there with data aggregation and statistical study of this data, etc.

]]> By: stisdalehttp://www.kevinmd.com/blog/2009/12/electronic-medical-records-improve-patient-care-cut-costs.html#comment-121070 stisdale Sat, 05 Dec 2009 03:30:22 +0000 http://www.kevinmd.com/blog/?p=41459#comment-121070 Jsmith, I am not motivated by money alone- I am more motivated knowing this may save my life one day. I got into this because of my mother- she passed away earlier this year.She had gall stones. Was an ER nurse for 20 years, and after what I saw for the 50 days that she was alive-- I know there is a better way. It may help me sleep better knowing that I have money, but I will sleep MUCH better knowing that I might have saved a life. The funny thing is a love a good fight! I could write a book on here about how watseful most things are in certain industries/government. We all could. But to find an affordable and permanent solution to a problem that has cursed an industry would be a wonderful thrill. Jsmith,
I am not motivated by money alone- I am more motivated knowing this may save my life one day.
I got into this because of my mother- she passed away earlier this year.She had gall stones. Was an ER nurse for 20 years, and after what I saw for the 50 days that she was alive– I know there is a better way.
It may help me sleep better knowing that I have money, but I will sleep MUCH better knowing that I might have saved a life.
The funny thing is a love a good fight!
I could write a book on here about how watseful most things are in certain industries/government. We all could.
But to find an affordable and permanent solution to a problem that has cursed an industry would be a wonderful thrill.

]]> By: cptmachttp://www.kevinmd.com/blog/2009/12/electronic-medical-records-improve-patient-care-cut-costs.html#comment-121048 cptmac Fri, 04 Dec 2009 20:56:14 +0000 http://www.kevinmd.com/blog/?p=41459#comment-121048 As a patient, what I like about EMR's is, it helps my doctors help me get better. I have a lot of weird drug allergies. There is no way that any doctor is going to remember them. One - reglan gives me medically induced Parkinsons. So, when I needed a colonoscopy, my GI doc automatically prescribed reglan. Because of EMR, an alert went to the pharmacy and to my GI doc.My GI doc called and e-mailed me. My pharmacist let me know he would not give me the reglan. All because a computer noted I should not take this drug. Some of my friends think my docs should remember every little thing about me, but I find this ridiculous. Even I, on occassion forget what I'm allergic to. Thank goodness a computer can remember. As a patient, what I like about EMR’s is, it helps my doctors help me get better. I have a lot of weird drug allergies. There is no way that any doctor is going to remember them.
One – reglan gives me medically induced Parkinsons.
So, when I needed a colonoscopy, my GI doc automatically prescribed reglan. Because of EMR, an alert went to the pharmacy and to my GI doc.

My GI doc called and e-mailed me. My pharmacist let me know he would not give me the reglan. All because a computer noted I should not take this drug. Some of my friends think my docs should remember every little thing about me, but I find this ridiculous. Even I, on occassion forget what I’m allergic to. Thank goodness a computer can remember.

]]> By: jsmithhttp://www.kevinmd.com/blog/2009/12/electronic-medical-records-improve-patient-care-cut-costs.html#comment-121047 jsmith Fri, 04 Dec 2009 20:37:26 +0000 http://www.kevinmd.com/blog/?p=41459#comment-121047 stisdale, I'm sure you'd like to sit down with docs, but as you can tell from the comments, a lot of docs are not so keen on sitting down with you ! But I wish you good luck. Innovation made this country great. If you come up something good at the right price, it will be adopted post haste. You'll get so rich so fast it'll make your head spin. P.S. We do in fact realize that EHRs don't cost millions. Tens of thousands is quite enough for something of absolutely no use. stisdale, I’m sure you’d like to sit down with docs, but as you can tell from the comments, a lot of docs are not so keen on sitting down with you ! But I wish you good luck. Innovation made this country great. If you come up something good at the right price, it will be adopted post haste. You’ll get so rich so fast it’ll make your head spin.
P.S. We do in fact realize that EHRs don’t cost millions. Tens of thousands is quite enough for something of absolutely no use.

]]> By: stisdalehttp://www.kevinmd.com/blog/2009/12/electronic-medical-records-improve-patient-care-cut-costs.html#comment-121045 stisdale Fri, 04 Dec 2009 19:57:26 +0000 http://www.kevinmd.com/blog/?p=41459#comment-121045 Et al, I have enjoyed the dialog that has come up with this subject. These points only solidify to me that a NEW approach must be implimented for EMR to work. Simple fact is, computers are here to stay and with GREEN being the new color- paper will not be around forever. A friend and I started EMDMC. Our company is trying a different approach with EMR. We are focused on the patient/doctors vs institutions/govt. It is web-based, and all you need is a simple computer, scanner, and intenet access. There is no million dollar licensing, or fees. Best thing is the patient actually gets to see their EMR (for a fee). More intergration to come as we get clients. www.emdmc.com ---Enough plug.I believe that paper will be here for maybe 10 years. It is tangible, and makes people feel good. But the simple fact, if a program can be taylored to each individual company, it becomes part of the company. It creates simplicity and makes the worker happier. Our company is taking that approach. We WANT to sit down with the doctors and help them create a program that they feel comfortable with, and most of all- simple and easy to use. The hardest problem with EMR is that it is aimed at the largest institutions, not common folks. How can you develop a new approach to something without getting interaction from the masses? Simply throwing money on a fire isn't the solution. The solution is working with the logs to create a long and steady fire that last much longer than a simple flareup. MISCONCEPTION--To doctors, EMR=MILLIONS of dollars and that just isn't so. Et al,
I have enjoyed the dialog that has come up with this subject. These points only solidify to me that a NEW approach must be implimented for EMR to work. Simple fact is, computers are here to stay and with GREEN being the new color- paper will not be around forever.
A friend and I started EMDMC. Our company is trying a different approach with EMR. We are focused on the patient/doctors vs institutions/govt.
It is web-based, and all you need is a simple computer, scanner, and intenet access. There is no million dollar licensing, or fees. Best thing is the patient actually gets to see their EMR (for a fee). More intergration to come as we get clients. http://www.emdmc.com —Enough plug.

I believe that paper will be here for maybe 10 years. It is tangible, and makes people feel good. But the simple fact, if a program can be taylored to each individual company, it becomes part of the company. It creates simplicity and makes the worker happier.
Our company is taking that approach. We WANT to sit down with the doctors and help them create a program that they feel comfortable with, and most of all- simple and easy to use.
The hardest problem with EMR is that it is aimed at the largest institutions, not common folks. How can you develop a new approach to something without getting interaction from the masses? Simply throwing money on a fire isn’t the solution. The solution is working with the logs to create a long and steady fire that last much longer than a simple flareup.
MISCONCEPTION–To doctors, EMR=MILLIONS of dollars and that just isn’t so.

]]> By: R Watkinshttp://www.kevinmd.com/blog/2009/12/electronic-medical-records-improve-patient-care-cut-costs.html#comment-121042 R Watkins Fri, 04 Dec 2009 19:10:05 +0000 http://www.kevinmd.com/blog/?p=41459#comment-121042 We've learned how dangerous it is to text while driving (most recent data: texting increases chance of an accident 24x, driving drunk 4x). Could doing data entry while doctoring be equally dangerous? We’ve learned how dangerous it is to text while driving (most recent data: texting increases chance of an accident 24x, driving drunk 4x). Could doing data entry while doctoring be equally dangerous?

]]> By: jsmithhttp://www.kevinmd.com/blog/2009/12/electronic-medical-records-improve-patient-care-cut-costs.html#comment-121028 jsmith Fri, 04 Dec 2009 17:52:25 +0000 http://www.kevinmd.com/blog/?p=41459#comment-121028 Kishore, Thanks for BMJ reference. And I was almost ready to cut you some slack until I read Alex's excellent post. The problem in a nutshell: Fact: Physician labor is scarce and expensive. Fact: EHRs force physicians to engage in activities at which they have a comparative disadvantage, like typing and scrolling and printing. (Please Google Ricardian Comparative Advantage if you are unfamiliar with this counter-intuitive but absolutely crucial insight of 19th century economics.) Conclusion: EHRs reduce physician productivity. If we didn't have to enter data or waste our time trying to find it on the EHR it could change the equation, as others have noted. If and when those systems become available, docs would be well-advised to look at them. But even the best of what we have now is junk. Kishore, Thanks for BMJ reference. And I was almost ready to cut you some slack until I read Alex’s excellent post. The problem in a nutshell: Fact: Physician labor is scarce and expensive. Fact: EHRs force physicians to engage in activities at which they have a comparative disadvantage, like typing and scrolling and printing. (Please Google Ricardian Comparative Advantage if you are unfamiliar with this counter-intuitive but absolutely crucial insight of 19th century economics.) Conclusion: EHRs reduce physician productivity.
If we didn’t have to enter data or waste our time trying to find it on the EHR it could change the equation, as others have noted. If and when those systems become available, docs would be well-advised to look at them. But even the best of what we have now is junk.

]]> By: IVF-MDhttp://www.kevinmd.com/blog/2009/12/electronic-medical-records-improve-patient-care-cut-costs.html#comment-121018 IVF-MD Fri, 04 Dec 2009 16:32:04 +0000 http://www.kevinmd.com/blog/?p=41459#comment-121018 It is morally wrong to force doctors to adopt EMR. In my practice, the natural drive to improve efficiency has made us do certain things electronically and certain things on paper so that maximal efficiency and best quality of care is achieved. For some intrusive bureaucrat who knows nothing of the daily practice of good medicine to arbitrarily dictate what we must do makes care more costly and inefficient. Of course, we have to question what their motivation is. Do they get pressure from the IT companies that stand to make big money? Is it for the benefit of the compliance attorneys who will need to be hired to make sure the EMR is HIPAA compliant? Special interests donate a lot to the politicians but the little everyday man and woman whose medical care is being compromised sadly does not get heard. Please educate the public as to one instance in history where bureaucratic interference has done less harm than good. It is morally wrong to force doctors to adopt EMR. In my practice, the natural drive to improve efficiency has made us do certain things electronically and certain things on paper so that maximal efficiency and best quality of care is achieved. For some intrusive bureaucrat who knows nothing of the daily practice of good medicine to arbitrarily dictate what we must do makes care more costly and inefficient. Of course, we have to question what their motivation is. Do they get pressure from the IT companies that stand to make big money? Is it for the benefit of the compliance attorneys who will need to be hired to make sure the EMR is HIPAA compliant? Special interests donate a lot to the politicians but the little everyday man and woman whose medical care is being compromised sadly does not get heard. Please educate the public as to one instance in history where bureaucratic interference has done less harm than good.

]]> By: gjuddhttp://www.kevinmd.com/blog/2009/12/electronic-medical-records-improve-patient-care-cut-costs.html#comment-121014 gjudd Fri, 04 Dec 2009 15:32:49 +0000 http://www.kevinmd.com/blog/?p=41459#comment-121014 It may be just me, but there seems to be considerable confusion here about differences between data entry, user behavior with respect to data entry constraints, and computation.EHR data entry is, in the main, abysmal, and should (and can) certainly be improved. Dismissing the potential of EHR due to the present realities of data entry and data entry behaviors is short-sighted at best. It may be just me, but there seems to be considerable confusion here about differences between data entry, user behavior with respect to data entry constraints, and computation.

EHR data entry is, in the main, abysmal, and should (and can) certainly be improved. Dismissing the potential of EHR due to the present realities of data entry and data entry behaviors is short-sighted at best.

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