Tech

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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When the EMR goes down

The hospital grinds to a halt:

IT people that work at a hospital: yes, your department now truly influences whether patients get better or worse, and indirectly, live or die.

Using an EMR

Dr. Rob with a typical day. Although difficult to implement, once an EMR is running smoothly, it becomes indispensable.

Electronic medical records: Expensive . . . and ineffective?

Much ado has been made touting EMR’s improving quality of care. So far, the data doesn’t back that up:

Electronic health records — touted by policymakers as a way to improve the quality of health care — failed to boost care delivered in routine doctor visits, U.S. researchers said on Monday.

Of 17 measures of quality assessed, electronic health records made no difference in 14 measures, according …

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Electronic medical records and the iPhone

Medgadget with the scoop on the latest:

Here’s an exclusive look at the first, and only, electronic medical record (EMR) compatible with the infamous iPhone. Everything from office notes to prescriptions, x-rays to echos can be viewed in all their multi-touch screen glory on the iPhone. Not to worry, this sexy little program isn’t just for hip, trendy physicians – soon even patients will be able to access their medical …

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Health IT: The next gold rush?

Concerns about the push towards EHRs and PHRs:

I am becoming increasingly concerned about whether the push for national-scale EMR’s has created a “gold rush” where prospectors of varied honesty and ability have set out to ‘strike it rich’ — by sucking every dollar they can out of an already strained healthcare system under pressure to ‘revolutionize care’ through computerization.

VA’s EHR

The strongest point of the VA system is their EHR. I used it extensively during medical school, and really is the only feature that should be copied from the VA system. DB and #1 Dinosaur comment on a Washington Post article.

Another EHR debacle

This time at UC-Davis. The transformation of medicine to the electronic age continues to result in some the biggest wastes of money:

A key observation is that “there’s nothing to show why existing staff was not assigned to do what the university paid outside consultants $17 million to do.”

Why EHRs are difficult to implement

Aside from the disruption during roll-out, many EHR programmers don’t really ask what physicians want. A typical IT top-down mentality:

Few developers have asked the physicians what they need. Fewer developers understand why they encounter such massive physician resistance. Those who have tried to understand the resistance can not get a straight answer . .

. . . I think the reason is that software developers are …

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The real scoop on EMRs

Here is the truth about the so-called “holy grail of medicine”:

Admittedly, other industries have seen large cost savings from computerization, but health care is different. First, the health-care system is hardly a system. It is hundreds of thousands of doctors and thousands of hospitals all practicing medicine their own unique way — and the EMR will not change that. Ideally, the EMR should allow a doctor standing in the …

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Fat Doctor on EMRs

It makes it easier for the charts to pile up:

When we had paper charts, I’d get freaked out if there were 10 on my desk. I’d quickly scribble out bare-bones histories, ROS, PE findings and plans. Now, it’s really easy to get behind very quickly. Part of the problem is the ability to be so darned thorough. I never felt that pressure with paper charts.

Templates are key. …

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Are EMRs affecting the doctor-patient relationship?

It seems so. Many EMRs are template-driven, so you have to work within its confines – rather than the other way around. I also was amused at how the doctor immediately announced how much time she had for the visit:

I was surprised, however, to see this new doctor enter the examining room with a computer on a cart. She didn’t greet me or shake my hand. Instead …

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TIME.com: VA hospitals are the best

Their EMR is a major reason. Although I don’t think it works this well:

Most private hospitals can only dream of the futuristic medicine Dr. Divya Shroff practices today. Outside an elderly patient’s room, the attending physician gathers her residents around a wireless laptop propped on a mobile cart. Shroff accesses the patient’s entire medical history–a stack of paper in most private hospitals. And instead of trekking to the …

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