Posted on 03/26/2009 3:38:55 AM PDT by tobyhill
Now that the federal government plans to spend $19 billion to spur the use of computerized patient records, the challenge of adopting the technology widely and wisely is becoming increasingly apparent.
Two articles, to be published on Thursday in the New England Journal of Medicine, point to the formidable obstacles to achieving the policy goal of not only installing electronic health records, but also using them to improve care and curb costs.
One article reports that only 9 percent of the nation’s hospitals have electronic health records, based on a survey of nearly 3,000 hospitals. The study, financed by the federal government and the Robert Wood Johnson Foundation, is the most definitive measure to date of the use of computerized patient records by hospitals. The government-backed study found a far lower level of use than some earlier, less rigorous surveys.
The study, the authors said, measured only the adoption of digital patient records. The survey did not ask whether the electronic records were used to advance the health policy goals of the federal plan, like tracking the quality of care and communicating effectively with outside specialists and clinics to coordinate a patient’s care.
(Excerpt) Read more at nytimes.com ...
Haste makes waste.
Pudlo’s thoery on database integrity:
“The bigger the database, the more prone to error it becomes, AND the more difficult it is to fix it.”
insert your most personal and critical data here, and see what’ll happen
This won’t happen in my lifetime. All those records will take years and years to convert. If they scan them, then someone will have to go back in and correct the scanning errors. Plus, there will be the MD handwriting problem.
Ah yes the famous physician (and even nurse) chicken scratch. Especially wonderful when what you’re looking at is a carbon.
Pharmacists’ jobs are secure. They’re the only ones who can read those hieroglyphics.
Main purpose for this is to ration healthcare for the elderly. Not that it doesn't need to be done on some level (I know seniors who are using lots of Medicare dollars for tests just so the physician can stay in "cya" mode.) However, isn't that situation better served by having a less litigious atmosphere.
And puts people’s lives at risk
Ugh. Most electronic medical records are a piece of crap. Slower to use and input information. Force you into limited choices. VERY user unfriendly. Also, just wait till the National Data base gets a false input like say, you have Syphilis, or it decides your dead, and try and correct that. Think having a messed up credit rating sucks? Just wait....
Go to any hospital that has computer workstations and you’ll see nurses sitting at those terminals instead of with their patients.
Bureaucratic weasel words translation: "We'll move the goal posts whenever we feel like it. It's not as if a contract with the government means anything, after all."
“Go to any hospital that has computer workstations and you’ll see nurses sitting at those terminals instead of with their patients.”
This started happening years ago when a ton of bureaucratic requirements for ‘charting’ were put in place. Nurses spend a ton of time writing in the chart or filling out other paperwork, instead of bedside care.
bump for later
I have had occasion to sign legal papers on a computer screen, using a mouse. THAT is awful to do and to read. Those electronic pads where you sign with a stylus are only a bit better.
How does the pharmacist reconcile those signatures with the actual ones from people used to pen and paper?
This entire records plan looks to be a boondoggle. It will require a literal army of workers and will take a decade, at least, and that is if they start this second with all electronic records and just have to convert the older ones.
Then you have the problem of fires, floods, and all the other means by which records have been lost or damaged beyond repair, like mold, insects or rodents. I have personally had my own records at one clinic lost due to a move. Given that we are experiencing a period of incompetent workers, that we have been warned of a failing electrical grid and threatened with rolling brownouts, there could be scenarios where months of conversion work are lost to grid failure or to extreme turnover in workers. In some areas, the physical realities of life could make this plan utterly unworkable.
I don’t think our rulers understand that they may never have this vast database, let alone be able to use it as a control mechanism. Things will fall apart way before they even finish compilation.
A pilot study is badly needed, to verify that the engineering can be done correctly and securely. Otherwise it will simply be Obama’s Halliburton, without even a won war to show for it.
There are at least two digital companies companies fighting for the hospital business and plenty of other products ready for the PRIVATE SECTOR. When Epic and Cerner put their patient products in place most doctors and hospitals can not only have patient records to share, but they can let the patient read their file and make comments to staff. This kind of stuff is all over the DFW market and does not need the governments help. If other places are slow to adopt - it is not about anything but business decisions.
Local hospitals here in Seattle Metro area conclude that EMR is more expensive to maintain and manage.
Advantages are quicker insurance reimbursements.
But overall costs are greater.
However, government weenies crave computers, MIS, etc., anything that brings semblance of intelligence and control.
But intelligence via MIS-like tech is inferior to highly developed brains of a competent MD. And therein lies the rub.
We would do better to layoff at least 50% of non-defense related government workforce.
“All those records will take years and years to convert.”
No way
The only reason the Feds want to track the “quality of care” is to REDUCE that quality.
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