Tech

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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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.

Update:
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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EMR, EHR, PHR, HIE, RHIO

Confused? Health IT guru John Halamka provides some clarity.

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