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11 electronic medical record posts you may have missed

With entries dating back to 2004, here are 11 classic blog posts on electronic medical records:

1. The low adoption rate of electronic records

2. Will physicians sacrifice for the future of health IT?

3. How to fund electronic medical records wisely

4. Medical students who are used to electronic records

5. Funding electronic medical records and bailing out the …

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How electronic medical records can lead to coding fraud, and get doctors into major trouble

The perfect storm is coming.

So says a cautionary article shows the dangers of adopting the current generation of electronic medical records. Many of these systems are template-based, leading to easy “cut and paste” documentation. Given the time pressures doctors are increasingly facing, there is tremendous incentive to over-document and over-code.

The subsequent uptick in higher-coding visits, like 99214s and 99215s, is catching the attention of …

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Are the elderly more technologically plugged in than doctors?

Almost half of patients over the age of 65 use the Internet.

Contrast that with the percentage of doctors who use computers in their offices or in hospitals, which is a number hovering around 20 percent.

Of course, that doesn’t mean doctors, in general, are computer Luddites. On the contrary, there are many who are trying to push the envelope, integrating the latest in social …

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Can the stimulus money save or worsen health care IT?

Billions of dollars are going to be spent modernizing our antiquated medical record system.

However, if these new digital systems fail to talk to one another, it’s simply going to balloon costs.

Consider this example, which occurs pretty commonly. A man is urgently rushed to a hospital 25 to 30 miles away from the one he normally goes to. Both hospitals have EMRs, but because they …

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Paying doctors by the hour will increase the adoption of electronic medical records

Less than 20 percent of doctors currently use electronic medical records.

One of the more cited reasons is that, in a fee-for-service payment system, doctors often lose money since the number of patients they see decreases during the long implementation phase.

Paying doctors by the hour will solve that problem. Consider this physician, who said “he had to give up his solo practice after he had …

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The New York Times finally gets it on electronic medical records

Their recent editorial on electronic medical records is bang on, albeit a bit late, as their conclusions have been discussed on the medical blogs for the past year or so.

The NEJM study in March, showing a 1.5 percent hospital adoption rate for comprehensive digital records, probably finally persuaded them. They acknowledge that, even though money is the primary issue, cash alone won’t solve the problem.

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Poll: Will electronic medical records really save money?

President Obama has called for the nation’s health care system to adopt electronic medical records ““ a move that he says will lead to 80 billion dollars in savings.

That figure comes from a theoretical study done in 2005. But analysts admit that real-world evidence doesn’t support the claim. For one thing, 100 percent of physicians would have to adopt digital records, while at the moment less than 20 …

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How much would you pay to e-mail your doctor?

One oft-heard complaint is how difficult it is for patients to talk to an actual physician.

The reasons are myriad, but the main factor is that doctors are not reimbursed for e-mail and telephone communication with patients.

A group in California is going to find out how badly patients would like to use e-mail as a communication tool. For an annual fee of $60, patients get the …

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Most hospitals still use paper records, and why money alone won’t solve the electronic medical record problem

New numbers have recently come out, highlighting how low the adoption rate is for electronic medical records in hospitals.

As reported by MedPage Today, the study from the NEJM found that only 1.5 percent of hospitals surveyed had comprehensive electronic medical record systems. That’s a piss-poor adoption rate, and far lower than the dismal numbers in small office practices.

The reasons cited are no surprise to …

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Will the benefits of digital medical records only be seen in large, integrated health systems?

I’m afraid the answer is yes.

An op-ed in the Washingon Post criticizes the influx of federal dollars to fund the spread of the current generation of electronic medical records.

Much of the data supporting the improvements in patient safety and the supposed cost-savings were done in large, integrated health systems, such as the VA, Kaiser Permanente in California, or the Mayo Clinic.

Unfortunately, …

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Can Wal-Mart help doctors implement electronic medical records?

Well, they’re going to give it a try.

In a somewhat audacious initiative, Wal-Mart is entering the digital medical records fray. They’re proposing to bundle computers and equipment, along with a popular EMR program, to sell to doctors at an attractive price. They’re probably hoping that bulk purchases with help with the pricing.

Will it work? It depends.

David Williams, although cautiously optimistic, …

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E-mails and telephone calls to the doctor cut down on patient office visits

Well, duh.

Many patient encounters, like those involving medication refills for instance, can be done without an office visit. An e-mail or telephone conversation would suffice in most cases. However, with Medicare and other private insurers refusing to reimburse for such claims, it is no wonder that many doctors insist on a face to face visit that gets reimbursed.

HMO Kaiser Permanente recently published a study …

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How the widespread adoption of electronic medical records can raise health care costs

One of the pillars of health care reform is modernizing our antiquated health records system.

That means pouring billions of dollars into the current generation of electronic medical records (EMRs), despite both the flaws, and the myriad of reasons why doctors are so resistant to go digital.

In an excellent piece, orthopedic surgeon Scott Haig points to why electronic records are not likely to save money, and worse, …

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How often do doctors ignore drug interaction warnings generated by electronic prescribing systems?

It’s surprisingly frequent.

WhiteCoat notes a study from the Archives of Internal Medicine looking at how often doctors overrode drug interaction warnings that pop up when prescribing.

I can say, at least with the EMR that I use, that it’s quite frequent, with warnings occurring when refilling medications that patients have been taking safely for years.

I’m not alone with this experience, as the …

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Health IT in the economic stimulus bill, should we be frightened?

Much has been made of Betsy McCaughey’s analysis of how the economic stimulus package will affect health care.

Although she takes a partisan swipe at the National Coordinator of Health Information Technology, perhaps what’s more frightening is that billions of dollars may potentially be poured into an inadequate health IT infrastructure.

Blogging over at Health Care Renewal, MedInformaticsMD asks whether government can succeed as the primary sponsor …

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Are hospitals the primary beneficiaries of the health IT stimulus?

There’s a lot to digest in the economic stimulus bill, but it appears that hospitals will be the recipient of the majority of the $19 billion allocated to health IT.

MedPage Today takes a closer look at the language and finds that “the Senate bill allocated about $19 billion to upgrade hospitals’ electronic records systems and limited how much an individual hospital could receive to $1.5 million . …

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Do electronic medical records lead to fraudulent documentation?

A known problem with electronic medical records is the use of template-based documentation.

This saves a tremendous amount of time, as paragraphs upon paragraphs of information can be documented with a single keystroke.

Problems arise when doctors, inadvertently or not, document history or physical exam findings that do not exist. The issue occurs more often than you think, and with the traditional mindset of “if you …

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Electronic records are supposed to reduce medical errors, right?

Those who advocate for electronic medical records cite a decreased incidence of medical errors.

The VA’s universal EMR, VistA, has been hailed as a model to aspire to. That confidence was recently shaken by an AP report, which disclosed a “software glitch” which exposed patients to wrong doses of medications.

One example included heparin, a blood thinner that requires close monitoring. Other problems included vital …

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Do electronic medical records really reduce malpractice risk?

News released last week suggests this is may be the case.

The study, published in the Archives of Internal Medicine, trumpeted that of the doctors who used electronic medical systems, “6.1 percent had a record of paid malpractice claims compared with 10.8 percent of physicians who did not use an EHR.”

In lieu of the lack of any improved patient outcome data associated with EHRs, proponents are trying …

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Why doctors are reluctant to adopt electronic records

Most of the rewards go to the insurance companies instead of benefiting the physician.

This piece by David Hamilton doesn’t break any new ground, and I cited a statistic earlier this year that doctors only realize about 11 percent of each dollar saved with EMRs.

Nonetheless, it’s a good overview of the obstacles facing every doctor who’s on the fence about going electronic. Office costs in …

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