Tech

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.

When EMR works like a dream

Or not.

OpenEMR

Ridiculous?

EMR realities

Sid Schwab: “The program is so unwieldy, my anesthesia buddy told me, that it’s slowing down the OR schedule. Surgeons need way more time to complete operative reports; the OR personnel wait in frustration until it gets done . . . because of the way the program is tied to current patient encounters, exacerbated by what sound like draconian penalties for lateness established by my former board (I was …

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Irrational health IT exuberance

MedInformaticsMD: “There must come a time when medicine’s professionals stand up for their profession and stop permitting politicians, business interlopers and other parasites from attaching themselves to medicine’s back and sucking the blood and sweat of its practitioners, and siphoning off capital better used to improve health.”

EMRs and malpractice insurance?

First time I’ve seen a malpractice carrier lower rates for physicians who use electronic records:

Northwest Physicians Insurance Co., one of Oregon’s largest medical liability carriers, is offering discounts to doctors that use computerized personal health records and e-mail to communicate with patients.

Depending upon medical specialty, the discounts range from $375 to $2,250 annually. That’s potentially greater than the cost of the secure e-mail or personal health …

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Template-driven EMRs

Attack of the clones: “What I see constantly when I receive EMR records from other practices (where the patient was first treated elsewhere and the treatments were not successful so they are now coming to me) is that the patients look identical. That is – I can see histories populated from checklists and quick electronic choices . . . The diseases all look the same. There …

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Another EMR fear

With so many vendors out there, there is always the risk of your vendor going out of business.

EMR exuberance

EMRs are being promoted as the Holy Grail. But, no one is willing to put money where their mouth is. Another example of sticking it to physicians:

Also, one wonders, say, why airline pilots are not forced to purchase, out of their own pockets, computers in their cockpits designed to prevent pilot error or collisions, but that in testing actually often doesn’t work, or just makes piloting …

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The free EMR

Free, open-source software, to run your medical practice on a shoestring budget.

"If government wants a national EMR system so badly, perhaps it should pay for universal EMRs"

Precisely.

Homegrown EMR

Why shell out thousands for an EMR when you can use Microsoft Word? Here’s the equipment that this urologist uses for a DIY EMR.

Why physicians aren’t buying the EMR Kool-aid

Physician’s don’t care about making the EMR the centerpiece of the patient encounter:

“You have to realize that physicians have been trained four years in med school, then three to seven years in post-graduate training. The funny thing is that they want to take care of patients. They don’t want to become specialists in creating medical records. They look at the medical record as an incidental cost of doing business. …

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EMR incentives

Good news:
Medicare is thinking about financially rewarding doctors for switching to EMRs.

Bad news:
It’s only going to be a measly few thousand dollars annually, which really amounts to zero incentive.

The carrot has to be way, way bigger to entice a switch.

Mandating EHRs

Doctors are forced to switch EHRs, or face being booted out of Boston-based Partner’s Health Care. Way to stick it to the little guy, who often has zero financial support to make the switch.

I can see Medicare and other big-payers using the same bullying tactics to force EHR adoption.

EMRs and ROI

Don’t expect much of a revenue boost. Any wonder why EMRs are so slow to spread?

One way to objectively measure value is return on investment (ROI). The news our survey delivers on this front isn’t particularly good. For every two respondents who say they have earned back in efficiency and revenue what they invested in an EMR, three say they have not. That’s despite the large number of …

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