<p>CF; Really, your tone of voice is over the edge…and leads to some rather unpleasant conclusions on the readers part. (Yes, my part - I have declared it so).</p>
<p>Conclude that I’m in a bad mood because the Sharks choked in an epic fashion last night, and I’m in no mood to put up with worthless “surveys” that produce no information of value because they have a tiny and self-selected group of respondents. </p>
<p>Whining that doctors need dragging out of the stone age, which someone claimed ended 1992 AD, misses the surgeon’s key point.
I suppose it’s possible he’s complaining about recording your peanut allergy for that future emergency room visit, CF, but doubtful. </p>
<p>.MODERATOR’S NOTE: I’ve received more than one report about posts in this thread. If I delete one or two posts, other people will get upset about something I “allowed” 287 pages ago. If I get any more complaints, I WILL close the thread. Please remain civil if you want this thread to continue.</p>
<p>Medicare penalizing doctors who don’t use EHR is exactly the dragging them out of the Stone Age of which I wrote. Medicare is dragging doctors out of the Stone Age by penalizing the ones who stay in the Stone Age.</p>
<p>One of you posted an article from Health IT before that reported on how upset docs were with the EMR. I gave reasons why the EMR is better for patients, regardless of what physicians say. </p>
<p>Here is another article from HealthIT which cites an example of exactly what I said in my previous post. This sort of thing is why it may be regrettable that docs are inconvenienced, but why healthcare experts are pushing the EMR anyway. </p>
<p><a href=“EHRs may help save lives from sepsis | Healthcare IT News”>News | Healthcare IT News;
<p>I’m not an expert on human-computer interface, but as it happens I am an expert on machine learning. Discovering a way to predict the early stage of sepsis is just the beginning of the kind of diagnoses we can learn to make once we get our hands on all that sweet sweet medical data.</p>
<p>Also, computers should be reading mammograms. </p>
<p>Scroll down to ‘Core and Menu Objectives’ and open ‘Stage 1 vs Stage 2 Comparison Table for Eligible Professionals’. Might not cross your eyes but you need to remember that not everyone has the soul of a central planner.
<a href=“http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Stage_2.html”>http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Stage_2.html</a></p>
<p>Seriously - if I’d gone to the back-breaking trouble and expense of becoming a doctor, this would really, really get up my nose.</p>
<p>CF really doesn’t seem to like doctors. Actually, I’m not a big fan of doctors, either. But, I do prefer them to politicians.</p>
<p>NOT using EMR put a number of patients at risk at the clinic where my daughter now works. She took over patients of a retired doctor. The former doc wrote several times on these patients charts that they should be checked for diabetes (like, at every visit over a year’s time for several of them). She ordered the tests after looking through the charts when she took over the patients, and every one of them had diabetes that had gone undiagosed/untreated. Had he used EMR the bloodwork would automatically been ordered.</p>
<p>Wait. Are some of you actually proposing we go back to non-electronic medical records? I agree that there are problems, both from the doctor’s and the patient’s point of view. So we fix the problems. We don’t go back to the horse and buggy. </p>
<p>Cat, that’s not the user-friendly version, ha. Its the heavy-duty, full bore stuff. Something akin to tech talk, not yet digested for them. Somewhere, there will be simple instructions and explanations- probably proprietary to the actual systems providers and their support staff. Over time, I believe we will see doc staff or local medical association staff trained to support practices. This wording isn’t unusual (imo/ime) for this specific sort of document. It’s not the final version practices would operate with, ime.</p>
<p>Medical research and pharm documentation is equally mind-bending to a non-trained person.</p>
<p>I looked at the regulations. What’s the problem? Those are benchmarks for the system, not for a doctor. In other words, they are design documents. They seem clear, concrete and well thought out.</p>
<p>Once the system is designed, doctors who use it will meet the benchmarks. None of the benchmarks seem unusual to me. </p>
<p>The system has to keep a list of the patients’ medication allergies, and what medicines the patient is currently taking. The system has to allow prescriptions to be entered and transmitted electronically. When a new prescription is entered, the system has to check that the new drug doesn’t have bad interactions with the other drugs the patient is taking, and that the patient isn’t allergic to it.</p>
<p>The system has to keep a list of what the patient is currently diagnosed with. The doctor has to record the patient’s weight, blood pressure, etc. at every visit. The doctor has to give a paper or electronic visit summary to patients that want it. The system has to send reminders to people that want them. </p>
<p>The system has to let all the care providers that take care of a patient see the patient’s information electronically.</p>
<p>And there’s some other stuff that is equally anodyne.</p>
<p>All of these criteria seem to me to be conservative, necessary steps that any practice using electronic records should support. I’m confused about what anyone would object to. I want my doctors to do these things. I would be annoyed if they had electronic medical records that didn’t support these things.</p>
<p>First of all, CF, you can read logically- that’s what it takes to follow that sort of document. Second, you seem to understand the context and purpose of what they are trying to collect. You’re not distracted by the fact it is freaking typed in to an- omg!- computer.</p>
<p>And, they have to do this for a target percentage of patients.</p>
<p>Do some of you realize this is a huge job opp field for our kids? (Assuming they are logical thinkers.) </p>
<p>Also, when med students are trained, there are organized categories of questions- some to explore history and symptoms, others to understand more in depth and breadth (and some social details.) Same as the processes for the physical exam. Basically the same categories the EHR will look for. If something is overlooked, it can be flagged. Some responses will have their own subsets of questions. Get away from the fact it’s a laptop, rather than a pen- and this is actually a tool for docs.</p>
<p>Put it in simple terms a vagrant can understand, LF, and the amount of time satisfying it is still… what, 10 to 20% of the day?</p>
<p>I’d guess that when the regulatory framework was written, those ‘poor hand-writing’ deaths were still front and center - good intentions, and all that, but don’t you have to wonder at the costs of those lost physician hours? The hours of them actually being physicians?</p>
<p>(And no - little of it other than procedural numbers, was confusing. Most regulatory bs isn’t confusing, just an enormous time-sink.)</p>
<p>Alas, my son is not a programmer. It’s a great tragedy for Mr. Fang and me. But I myself would love to get my hands on some of that anonymized data. There are so many ways we could help people and reduce costs, if we could figure out which people didn’t need to be treated, and what conditions were about to be go bad and should be gone after aggressively.</p>
<p>For example, doctors recently discovered that babies born by scheduled C-section before the 39th week of pregnancy are a lot more likely to have respiratory problems. This particular study was done by groveling over medical records, but it’s the kind of research query that could be answered in a snap with well-designed electronic medical records. And it’s the kind of data we want to know. We don’t want little babies to have lung problems because someone thought it was convenient to deliver them at 37 or 38 weeks and nobody realized it was a bad idea. And yet, that’s exactly what was happening.</p>
<p>What other simple changes can we find out once we have the data in a handy format? What information can we find out about uncommon but not that uncommon diseases?</p>
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<p>My doctors have electronic medical records, and as far as I can tell, the doctors do pretty much what they always did. The nurse or assistant takes my height, weight and blood pressure, and then runs through my med allergies and what meds I’m taking. Then the doctor comes in and does the doctoring, and if there is a prescription, she enters it. The doctor keeps records of what happened at the visit, but my doctors have always done that. So, maybe the records system has a nasty interface, but the doctor seems to be doing the same thing she did before the advent of the records.</p>
<p>^^Exactly, lost face time/interaction with patients. </p>
<p>In most offices, single private practitioner, the office staff are less computer literate than the doctor. </p>
<p>Doctors are playing IT professional within their own practice. I know as I am a licensed health prof audits/analyzes EMR information/disease tracking etc. I visit a wide area of practices hospitals individual offices etc. Right now, those who put the rules in place, let the horse out of the barn.</p>
<p>One would have thought the information would be streamlined, efficient yet it is not, not even close.Protected information is vulnerable, not all encrypt their data when it is sent. </p>
<p>Those offices which are fortunate to employ an IT department, (another layer of cost to a practice) will have secure sites, but all it takes is one breach, and anyone in an office can unknowingly undo a firewall. </p>
<p>CMS rules change as often as every 6 months, doctors/staff are always trying to play catch up. </p>
<p>No wonder most doctors are abandoning solitary practices and joining corporations, and becoming employees, the headaches they currently have to deal with are not ones I would want. </p>
<p>Glad your experience validates your view, CF.</p>
<p>Mine is being asked the SOS they’ve asked every time by everyone from the desk clerk to the doctor, all of which they dutifully enter into their computer. Maybe they’re genetically dull or maybe they just don’t know about RAID hard drive configurations?</p>
<p>Lately, I have been handed an IPad that no-one in the office seems too familiar with and been asked to go through approximately 5 pages of check boxes. I generally just check no. But, it’s a lot of annoying and completely useless.</p>