Health Information Technology is becoming a bit of a family affair, since my brother, who is an (excellent) ophthalmologist practicing in a fee for service environment, has been pondering electronic health records. His practice is far from the halls of the US Capitol, so I think his viewpoint is an important view of the reality of the overwhelming majority of medical practices in this country. It’s worth a read, so I’m reposting it here. Our conversation was stimulated by two pieces of research recently published (linked on the right).
Sure, you’re welcome to publish anything you want.
I agreed with your assessment. Just as a computer at home or having a smartphone doesn’t really save any time or money, it does make us more productive.
I have no doubt a well written emr will be beneficial to medicine, but I doubt it would be any huge time or money saver.
I dont know any doc with emr, that is more than marginally happy, and no one that saves money or time. And, the records I get are useless, as they are all macro’d out and two pages for a 30 second exam.
In fact they may cost insurers more, because some are marketed as ‘printing money’ for being able to tell you what you need to add in order to upcode the visit.
Right now, I think it is the quality of emr’s that is the problem, at least for ophthalm as we do alot of drawing and do alot of tests that need to be digitally incorporated.
But, I can’t imagine not having an employee file and pull charts wouldn’t save money. And, I would just love for a referring doc to just transmit a patient’s history to be incorporated into my records when they are referred. Likewise, instead of sending an email regarding a patient I am sending a retinal doctor, (which they probably forget), I would love to just send my records over so they know what I had the question about.
The big issue now is the privacy/audit issue. There are now companies that specialize in auditing charts for medicare and private insurers, and getting commission. Much easier to do with emr, as we can just transmit the chart. But, with paper charts, they can’t read them well, and they don’t plan on doctors copying dozens of charts, so they kind of give up.
What do you think? If we believe (as I do) that all doctors are driven to perform well for their patients, what’s the gap here, and what needs to be fixed?
Click below to see what my original response to him was….
