Funding electronic medical records and bailing out the Big Three automakers

Barack Obama wisely wants to spend money to modernize the country’s antiquated health records system.

But is throwing money on old, flawed technology to right course of action? Emergency physician Rick Peters (via David Catron) thinks not, as the spread of first-generation EMR programs will simply lead to “across the board loss of clinical efficiency, a loss of productivity and a counterintuitive increase in the number of personnel, …

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How to fund electronic medical records wisely

There’s the easy and the hard way.

EMR guru David Kibbe is encouraged that Obama is promising to spend the necessary resources to fund electronic records.

However, using it to simply allow doctors to select from the current potpourri of eclectic, disjointed programs may be easy, but not wise, as “it would only dramatically intensify the Babel that already exists.”

If it were up to me (and …

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Will electronic records actually increase health costs?

Much has been made of the ability of EMRs to save money through increased efficiency.

Cardiologist Dr. Wes doesn’t believe it, as these digital systems make it much easier to order tests as well. Alerts and clinical pathways abound that make ordering expensive tests and consults as simple as clicking a mouse.

So in this case, “efficiency” has the potential to balloon spending, as “panels of …

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Are poor products to blame for the slow adoption of EMRs?

Not so, says this primary care physician.

Dr. Rob tells us to stop blaming the current crop of programs, and simply admit that it’s difficult to fundamentally change your practice in order to install a digital record system.

He says that it’s similar to the decision facing those who consider buying hybrid cars, saying “you could spend more money for gas efficiency, but why?” He advises doctors …

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Poll: Top health care issues you will face in 2009 as a practicing physician

Welcome listeners from ReachMD! I am pleased to be hosting the ReachMD Poll, where I will introduce a topic on-air and you can have your say and vote on important health issues.

Health care reform is imminent, and the coming year will present many challenges for the medical profession. What are the top health care issues that you will face in 2009 as a …

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Will physicians sacrifice for the future of health IT?

Health IT guru David Kibbe writes that simply adopting electronic records aren’t enough. For one, many EMRs don’t talk to one another, and this loses one of the fundamental advantages of the digitization of medical records:

Many EMR vendors have resisted the call to make their software capable of exporting and importing a standard set of summary personal health data in computable format such as the Continuity of Care …

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Paper charts

Electronic records are a recent theme here. #1 Dinosaur give his take in a Medscape piece (registration required), calling the current crop of EMRs nor ready for widespread use:

The EMRs promise of a “paperless” office is as distant as ever. It’s much easier to keep my efficient, time-tested paper charts than lay out thousands of dollars for hardware and software that aren’t going to save time or …

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Implementing electronic records

A technologist notes some of the pitfalls obstructing widespread EMR adoption. One important point is that those behind the systems don’t know how doctors work, or what makes their lives easier.

Until they do, and can come up with systems that improve physician’s lives, resistance will continue:

A large percentage of technology professionals are about the machine. They’re about the what and the how. They’re not about …

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EMRs: Not ready for prime time?

Thanks everyone for your comments on my piece on EMRs earlier this week.

It’s interesting to follow the ensuing discussion around the blogosphere, and there were a few comments that caught my eye. Like this one:

Most of these computerized record systems are not ready for prime time! They have major faults – it can often take significantly more time to complete an electronic record than to dictate the …

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EMRs and your life

Will it make “your life is hell for the next year?”

The answer is yes. It takes about 6-12 months for electronic records to fully manifest into the patient workflow, and for doctors to feel totally comfortable with the system.

It demonstrates how poorly designed many of the programs are, evidenced by the lack any kind of physician input in the user interface.

EMR-associated legal woes

Dr. Wes points out how easy electronic records make it for lawyers to go fishing.

EMRs and EHRs

When it comes to electronic record terminology, I’ve assumed that electronic medical records (EMR) and electronic health records (EHR) were interchangeable.

A kind reader pointed out that they are not. Here’s the subtle difference.

Link fixed.

Medical records and Facebook

Provocative piece by hospitalist el jefe Bob Wachter. He laments how archaic most electronic records are, and I agree:

You’d think that medicine’s conversion from paper to electronic records would solve many of these problems, but ““ to date ““ all it has done is create new-fangled electronic silos. In most EMRs, including the GE system we’re using at UCSF, the notes are really just electronic incarnations …

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Google Chrome and electronic records

I haven’t tried it yet, but will soon. I’ve read that its Java and ASP processing is unsurpassed, in anticipation of Google re-inventing the operating system that will work solely through its browser.

How does this apply to electronic medical records? If Google Chrome takes off, Canadian EMR suggests that the next generation of EMRs will be ASP-based and will make Windows-based systems obsolete.

This …

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Confused? Health IT guru John Halamka provides some clarity.

The PMR is not the EMR

Dr. Wes: “The EMR contains the official transcript of your healthcare received. The EMR is the ultimate arbiter of healthcare delivery that is the undisputed king of records used in liability proceedings. As such, there is little incentive for physicians to maintain two sets of records. The Personal Health Record is just that: personal. It is NOT a health record. Sorry.”

Electronic records by 2014?

There’s a reason why universal electronic records are nothing but a pipe dream:

The high cost of EMRs, combined with a small return on investment, is a main reason why physicians have been slow to adopt systems . . . While some EMR functions, such as billing and transcribing notes, financially benefit physicians, most of the return on investment accrues to health plans.

Physicians should be in charge of implementing EMRs

Not enough are, which is why so many of them fail.

Skin in the game for electronic records

Charlie Baker argues that the physicians need to have some financial stake in EHRs in order to be successful:

I’m all for more EMRs, but I continue to believe that EMRs will only work if they’re paid for – at least in part – by the people who use them. If the technology’s free, it won’t get treated with the proper level of diligence and respect that it needs to …

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EMR tips

A family physician implements an electronic record system and shares her experiences.


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