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Studies Show Electronic Medical Records Make Financial Sense

IGBT

IGBT

Lifer
Text

I wonder if patients will have personal access to their own records??

But one of a series of new studies in the September/October issue of the journal Health Affairs addressing the adoption of health information technology suggests that although adoption is slow and risky, it can pay off for small practices. And if enough health care providers implement electronic health record technology, the payoff in savings for national health care in the United States could be significant, according to another study in the same journal.

Only 12 percent of practices with five or fewer full-time physicians reported having functional electronic health record systems, according to a nationally representative sample of physician practices on their use of information technology. Overall, including larger practices, about 18 percent are using electronic health records. But that figure has remained almost unchanged since 2001. However, 34 percent of practices surveyed said that they planned to implement EMRs within the next two years.
 
interesting. When I took my son in for his 4 month appt this week, everything there was on computers. THey entered everything in and gave us a printout at the end. I think it is a great idea. No more paper, no more unreadable notes, and another thing...no more prescription pads. Yep, if he was to prescribe something, it would go electronically to the pharmacy of our choosing. Very cool
 
It's' all very cool - until someone cracks the server and sells your records, and someone then phones you and threatens to tell your boss that you are taking antidepressants. Or your wife that you were treated for VD, or your neighbors that your daughter had an abortion.

We can't even control CREDIT CARD information - and that can be easily cancelled and a new one issued. The only people that lose to credit card fraud are the banks (ultimately we pay for it through bank fees elsewhere, but directly it's the banks). And yet, after all this time and effort - personal data still gets stolen by the truckload.

Is that the future you want for YOUR medical records? Your wife's? Your children's? Unlike credit cards, your medical records can't be cancelled and new ones issued. Replaced - but the original is still flying about...

Think about it.

Future Shock
 
gee, if EMR make so much much "sense", how come almost nobody uses it? Oh, and don't tell me doctors are stupid and you just know better.

not ready for prime time...

this isn't about playing DOOM on your computer, this is about taking care of people, and running a business.

extraordinary degree of reliablility, stability, flexibility and security is manditory. Ease of use is manditory. hard to beat paper!!
 
Originally posted by: heartsurgeon
gee, if EMR make so much much "sense", how come almost nobody uses it? Oh, and don't tell me doctors are stupid and you just know better.

not ready for prime time...

this isn't about playing DOOM on your computer, this is about taking care of people, and running a business.

extraordinary degree of reliablility, stability, flexibility and security is manditory. Ease of use is manditory. hard to beat paper!!
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Eh, a lot of the old farts don't want to learn new tricks . . . I mean it would take a lot of practice to illegibly render a prescription by Bluetooth.

The primary reason EMR hasn't taken off is that somebody has to pay for it. Government has the money (sorta) but lacks the will. Insurance providers have the money, but there's no guarantee of return on investment. Hospitals have the money they siphon from government, but not enough to fund their own systems. Small providers don't have the money.

If the primary concern of all parties involved was taking care of patients, we would have a good EMR system already. Unfortunately, healthcare in America is primarily about making money.
 
<--Big fan of EMR's as only a nurse who's looked for a paper chart for a couple of thousand cumulative hours can be.

Current jobs-

1 is 1/2 EMR because the physicians are unwilling to do order entry (jackass mf's don't understand how dangerous it is to read their handwriting while squinting & holding the paper sideways & trying to remember what that doctor usually orders and dreading yet another phone call to the busy doc to clarify WTF they actually wrote)

2nd job is 100% paper, sigh...

Personally I think the VA Hospital's software should be mandated for all Medicare billing recipients, it'd put everyone on the same page, same verse, when patient is transferred, they coul burn a CD of the records & send it along with the patient.

VA's CPRS
 
There are a couple of problems with EPRs which it's worth pointing out.

Presently, there are a number of different systems - many of which are incompatible, and will require substantial engineering to get them to communicate. It's not uncommon to see a different system in use for different departments in a hospital. E.g. Pathology (blood tests) may use one system, radiology may use a different one, and the main ward work may be recorded on another.

At the hospitals I've worked at, there are big problems accomodating temporary staff where the ordering of tests/retrieval of results are fully electronic. As temp staff are often obtained at short notice for an unsocial shift, it's often necessary for such staff to 'borrow' someone elses user ID and password, until the next working day (if they're there that long). Where medical records need to be made, this can be a serious problem.

EPRs can make it slightly easier for notes/results to be filed in the incorrect patient record - and more importantly, there is little way for a 3rd party who reviews these notes at a later date to be able to see the error. I've personally had to clean up the mess after a couple of potentially serious medical errors that occured because somehow, the wrong test results had got into someone elses file, or immediately dangerous results had got lost because the lab was unable to work out which record they were supposed to go in.

Although it's very nice to be able to classify diagnoses according to recognised systems - e.g. ICD-10 or SNOMED, many doctors are not at all familiar with these coding systems, let alone some of their intricacies. One scenario I've come across - a urology department does a lot of minor surgical procedures called 'cystoscopies' - essentially a telescopic examination of the bladder. However, there are different codes depending on whether the procedure is performed for a cancer check-up, or for investigation of other bladder conditions. If the system doesn't check that a 'cancer' procedure is being performed for a 'non-cancer' diagnosis, then you can get confused data, which can then be very difficult to correct. This can cause distress to patients if they see it in the record, and cause confusion when individual doctor's/department's performance is assessed.

Lots more problems I've seen too - e.g. doctors (particularly those unfamiliar with computers) tend to prefer to write free text, rather than using a fixed format. E.g. Instead of putting Blood pressure in the blood pressure box, they might just write in the 'comments box' - 'well. no side effects from meds. 120/80' Auditing such records is very difficult.
 
Mark R hits on a couple of very important "road bumps" to a good EMR/EPR system. What's most important is 1) the will to do it and 2) the resources. At the moment, I really don't see either.

IMHO, patients will benefit the most (increase in speed of care, quality of care, and reduction in medical errors) but they have essentially no advocates in the process. Individual departments and hospitals will continue tinkering with EMR systems but few if any will switch over any time soon.
 
Originally posted by: Whaspe
You in med school IGBT? I think this has more to do with the changing of the guard than anything else.
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There's no such animal as "changing of the guard" when it comes to medicine. You get into medical school by "looking" somewhat qualified. You get into a residency program by "looking" like the people that run the residency program. You get a faculty/staff position by "looking" like the people already on faculty/staff.

No matter how intelligent AND idealistic you may be . . . by the time you get through the "processor" . . . you "look" like a decent fascimile of those that came before you.

A more fundamental problem is that physicians don't run this puppy anymore. Fee-for-service has been on life support for decades. The largest players are now government, large insurers, PBM (pharmacy benefit managers), Big Pharma, and hospitals. Granted, many people in leadership positions have an MD but if their primary concern was "improving patient care", the detour to Wharton, Sloan, Haas, and Kenan-Flagler seems a bit odd.



Although the OP title is taken directly from the referenced article, it's quite misleading. It would be ridiculous for a small group (<5 MDs) to risk their practice trying to implement an EMR. If someone gave them an EMR it would be totally different issue (merely cultural as opposed to fiscal). There's absolutely NO economy of scale if individual groups select their own EMR system and nothing is established to ensure interoperability.

Again, I'm not saying EMR is a bad idea. I am saying many of the advocates don't understand our healthcare system. "Just Do It" isn't going to cut it.
 
it's with neverending amazement that people who have absolutely no personal knowledge of what medical records contain, how the goverment regulates them, billing requirements, costs, legal requirements, etc....

are convinced that they know a better way to do "it", without ever knowing what "it" is.

if maintaining medical records in an electronic form was "cost-effective" don't you believe that everyone would already be doing it?

why don't one of you self proclaimed geniuses whip up a cheap, easy to use,secure, robust, interoperable medical records system that "saves money" and market it? You'll make a fortune and help mankind in the process.....

come on, i'm waiting (the idea of EMR have been around since the 1970's....still not ready for prime time)

by the way, medical records are not the property of the patient.
 
Originally posted by: 1EZduzit
Originally posted by: heartsurgeon

by the way, medical records are not the property of the patient.
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The information contained in them belongs to the patient.
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He's not that simple . . . he just forgets the details when he pops his top. Obviously, you cannot enter a facility and take "possession" of your medical record. Granted for a nominal fee (at my institution), you can get a copy of your medical record.

Now getting a sensible document from billing . . . that's hard.
 
Originally posted by: Whaspe
I think this has more to do with the changing of the guard than anything else.
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In the ER EMR's kick ass, you can pull up medication profiles, past diagnoses etc instead of reinventing the wheel on every visit.

An entire generation of physicians needs to die off first though🙁

 
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