Examining Electronic Medical Records

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Bill Bartmann of AL 1:43PM September 02, 2009

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soundtracks of AL 7:05AM July 17, 2009

As a patient the first thing that happens when I go to a doctor or a hospital is I get handed the dreaded clipboard . I am asked to fill out all my personal contact information, age,medications that I am allergic to, illnesses and diseases I've had. For the umteenth time.
I've often why I have to fill out the same information for every doctor and hospital I visit.
Now I know.
Doctors are living in ancient times.
In an age where everyone has a personal computer and every business would grind to a halt without their PCone , The medical field is still living in the dark ages where everything is being kept in file folders stuffed slips of paper on which is written important information in handwriting that I am sure only the doctor can read.
Which leaves me wondering if the treatment I am being given is as outmoded and out of date as the record keeping systems doctors are using.

Norris Hall of CA 11:21PM April 08, 2009

We need to pay attention to those suffering from or supporting someone who suffers from a chronic disease: The current, fragmented and episodic delivery care fails to measure up to the standards possible - and rightly expected. Most of the objections are rooted in an unwillingness to change old, often bad, habits, or are fed by the bogeyman of privacy concerns. The first group, frankly, has to smell the coffee - or will be passed by others that get it. The latter group has some legitimate concerns that need to be dealt with frankly and openly, through appropriate governance and stewardship of databases. We must 'get with the program': Too many of our patients receive less than optimal care - and many are actually at risk because of our out-dated prctices.

Bob Burns MD 1:14PM April 07, 2009

As a doctor I am daily reminded of how efficiently capuring data helps my patients by having all of their data at my fingertips.
Imaging and lab results available without someone needing to pull the file and re-file it. Improved ledgibility and completeness of records due to digitized formats. The patient's ability to record their subjective complaints and complete outcome measurements at check in through touch sreen prompts.
This technology also helps me to run my business by allowing real-time posting of diagnosis and procedure codes, dispensing with much of the photocopiing and mailing of data and billings, freeing up staff requiremnts. Ther is potential for greater reimbursment due to digital requirement of some payors like Medicare
However, there are several detractors including the set-up and learning curve required to use such software. Cost of the hardware, software and technical support is approximately $25,000 for the first 3 years, in my clinic. Vulnerability of the data to electronic or criminal interference is potentially increased verses paper documentation.
So, for me, it boils down to stepping out of my personal comfort zone and embracing the future while adapting to and investing in the digital matrix or remaining in the relatively comfortable, known, paper system.

T.D. of OR 2:53PM April 04, 2009

The issue I continue to see with the advancement of any EHR is what the expectations of providers and clinicians are. We talk about access to data, but what does that mean. Does it mean that press a button and have a lifetime of data available to me in under one second? Does it mean that I expect data to be aggregated over 5 years for one data point like lab level? The reality is that much more has to do with the next few years and adjusting to change and setting realistic expectations than anything. We will always hear the stories in the electronic work and paper world about "lost data", and no matter what the research may say, people will believe what they want to support the position they hold. We know that the number of medication errors that occur using paper records to dispense and pass medications in a hospital. We have data to support the decreased errors in medication dispensing using an electronic system, yet we still hear the "I'm afraid", "I don't trust" comments.
We are not going to be able to go to a true EHR system of any kind and realize the benefits until we deal with the human factor of not wanting to change. Clinicians and Providers continue to try to use old practices and workflows with a technology the requires you change all of those. And it simply will not work that way.
Change can happen, but we have to recognize the level of this change and understand that we can't jam bad workflow and processes into a new technology solution and expect miracles to happen. There are a some key people who are working in this area, but overall, the healthcare profession in general is slow to adopt and/or accept real change to the way they work or their processes.

George Grayson of TN 8:12AM April 01, 2009