Skip to comments.EHR: The Grand Illusion (electronic health records)
Posted on 03/15/2010 8:14:04 PM PDT by neverdem
DR. WAX is a family physician based in Mullica Hill, N.J. He reports having no conflicts of interest related to this editorial.
I consider myself a computer literate physician. In high school, I taught myself to program in BASIC on my Atari 800, which had a whopping 48K RAM. In college, I transitioned to the Apple Macintosh. At medicine morning rounds, I saw the Palm Pilot Pro and had to have one. I've been desktop and mobile computing ever since.
I had spent the past 6 years investigating electronic health record (EHR) systems when, finally, on Black Friday 2009, I took the plunge and bought $10,000 worth of computers and another $2,000 worth of peripherals and uninterruptible battery backups for the server and client machines. Thanks to a sale, I got an 8% discount on the machines and shipping was free. I selected a software company for the EHR that has been in business for over a decade, which involved another $8,000 investment in software and support for the year to get started.
Yet instead of getting the system roaring off the launch pad, I spent many hours just trying to get the computers networked with the server and the software. Finally, I resorted to the computer store's suggestion and hired a dedicated consultant on an hourly basis. In my case, it took over 8 hours, at $175 per hour, to get the system configured.
Next came the software training by the company with prepaid support. Straightforward, right? Wrong. First we needed to export our patient demographic data from our outsourced billing company and get it to the EHR vendor. Two weeks after the data got therein HIPAA compliant fashionwe were told that all 3,700 names and related information needed to be retyped. Can you hear the cha-ching?
I have spent the past 2 months experiencing all the symptoms of stress: insomnia, generalized anxiety disorder, gastroesophageal reflux disorder, and irritable bowel syndrome, mixed type! Perhaps when my EHR has been in place and running for 6 months, I will feel differently.
Just why am I doing all this?
The U.S. government's Health Information Technology for Economic and Clinical Health (HITECH) Act proposes reimbursing practices up to $44,000 over 3 years to adopt these systems.
It sounds great, but the devil is in the details. No one but the user will absorb the $1,000-$10,000 or higher annual cost for service, support, and equipment repair and replacement. Current insurance reimbursement contracts don't allow us to raise our charges to help offset the EHR business investment.
I have been electronically prescribing since Jan. 1, 2009. Experts insist that it is faster, cheaper, and safer than written scripts, but the reality is that I can call in a prescription or write one faster than I can key it in. Electronic prescribing costs significantly more than Rx pads. Finally, at my office, there were more dosage and quantity errors electronically last year than during any previous paper-based prescribing year.
Electronic prescribing may seem really cool, but when I called CMS today to inquire about the bonus I was to be paid for doing it electronically, they told me that it might be sometime in the fourth quarter and they didn't know how much it would be. Need I say more?
The HITECH Act subjects physician practices to all of the liability issues to which all other computerized businesses are subject to. We will now be on the hook for privacy and security issues for patient information. Violators will be subject to penalties and forced to notify all patients who were compromised. We might even have to put ads in local papers describing incidents.
I do not look forward to the morning when my office relies heavily on the EHR system and my computer does not boot up. Patients will have to wait while we call software and hardware support and they return our call within 24 hours.
If the government and insurance companies have full control of health-related data and every aspect of health care, patients' privacy will be a thing of the past. The promise of efficiency and enhanced reimbursement for physicians (pay for performance) becomes meaningless in the face of this monumental waste of time and money.
Paper is cheap, reliable, and firmly established in the medical community. EHRs are expensive in terms of time and money and their value is unproven. Think long and hard before you commit the time and investment to buying a system. The necessity of EHRs and the government/insurance industry promise to make them worthwhile are a grand illusion.
To err is human. To really foul things up requires a computer.
Whoever comes up with a reasonably priced turnkey system to do this will get very rich.
TriCare is the sloppiest organization the US govt.
“To err is human. To really foul things up requires a computer.”
Well, computers are good with that. But I’ve seen some human doozies.
I'm also not thrilled with having my medical records available to any bureaucrat that doesn't like something about my life style choices. If I want a new doctor to view my records I will get them from the previous doctor and give they to the new doctor or I will get a CD of my Xrays, Cats or what ever else they might need.
I don’t want electronic records.
They will compile unrelated symptoms to come up with a diagnosis.
In other words, sometime TMI is just that...too much information.
FReepmail me if you want on or off my health and science ping list.
Electronic records of all personal information is my greatest fear of the health bills. It will come but should be at individual organization’s pace. The level of user incompetence in the average office is absolutely astonding. The bills are unbelievable. The fact that any government union member could view anything they want at any time is absolutely freightening.
What was supposed to help and "protect" patients has hospitals and facities spending all kinds of money and effort to protect themselves because the unhelpful HIPAA regulations have made the hospitals and providers targets for HIPAA violation lawsuits and fines.
Just wait until the consultants start pitching SAP as the way to make electronic medical records run smoothly.
My question is if liberals insist on public ed. and idiots graduating from lib colleges, how the heck can they promise themselves to run or design such arcane systems from hell?
“The fact that any government union member could view anything they want at any time is absolutely freightening.”
Stalkers of our lives and moneys are multiplying just like ambulance chasers. Gnashing of teeth is felt with every liberal sullen look combined with a lip piercing, all so insecure and incapable of living without a government hand in their own lives.
“Freightening” and stupid is right. Whenever we hear of a teacher investigated but not punished for sexualy harassing a minor (because that would be violating the kid’s privacy, golly), read: SEIU Zero/lawyer protected specie.
That’s the problem - the turnkey systems to do this don’t fit the practice workflows. The FACT is these are not about helping doctors work faster, they are about collecting information on patients for the government death panels... err... improving the ability to data mine the data.
It’s a tough nut. Certainly a worthy goal. If I were a PCP, I would drag my feet as long as possible and hope that better solutions were available when I’m finally forced to take the plunge.
Just had a report to the board at our local health care center. Electronic Medical Records was implemented about 9 months ago. They used the carrot and the stick to get us to do it, so the government helped pay for the equipment.
Currently, our producer productivity has been reduced by 50%, and the patients hate it because the office visits are slower.
It can also cause hours of delay when the system crashes.
Tea Party are planning a protest at the Millington TN office of Rep John Tanner tomorrow just before noon.
Defeat Obamacare call list: List now contains the new MAYBES culled from FR posts. Be sure to call KNOWN RINOS too.
KEEP THE CALLS UP! DC OFFICE LOCAL OFFICE
Code Red - House Target List on Health Care
The National Republican Congressional Committee has published a target list on health care. In addition to continuing to contact the five Tennessee Democrat Congressmen, you can go http://www.votervoice.net/link/clickthrough/ext/94697.aspx to contact some of these targets. Much of the talk following Obamas announcement has focused on how to defeat this second bill through reconciliation, but that is misleading because the first step to defeating Obamacare is not by concentrating on defeating the fixer bill but by defeating the Senate bill in the House when it goes to the floor for an up-or-down vote on Thursday, March 18th.
Rep. Lincoln Davis 202-225-6831 Columbia office: 931-490-8699
Rep. Jim Cooper 202-225-4311 Nashville office: 615-736-5295
Rep. Bart Gordon 202-225-4231 Murfreesboro office: 615-896-1986
John Tanner (202) 225-4714, Union City, (731) 885-7070, Jackson Phone: (731) 423-4848, Millington (901) 873-5690 TN (MAYBE)
Rep. Steve Cohen 202-225-3265 Memphis office: 901-544-4131
Harry Mitchell (202) 225-2190 (480) 946-2411 AZ 5th District
Gabrielle Giffords (202) 225-2542 (520) 881-3588 AZ 8th District
Ann Kirkpatrick (202) 225-2315 (928) 226-6914 AZ 1st District
Jerry McNerney (202) 225-1947 925-833-0643 CA 11th District
John Salazar 202-225-4761 970-245-7107 CO 3rd District
Jim Himes (202) 225-5541 (866) 453-0028 CT 4th District
Alan Grayson (202) 225-2176 (407) 841-1757 FL 8th District
Bill Foster (202) 225-2976 630-406-1114 IL 14th District
Baron Hill 202 225 5315 812 288 3999 IN 9th District
Mark Schauer (202) 225-6276 (517) 780-9075 MI 7th District
Gary Peters (202) 225-5802 (248) 273-4227 MI 9th District
Dina Titus (202) 225-3252 702-256-DINA (3462) NV 3rd District
Carol Shea-Porter (202) 225-5456 (603) 743-4813 NH 1st District
Tim Bishop (202) 225-3826 (631) 696-6500 NY 1st District
John Hall (202) 225-5441 (845) 225-3641 x49371 NY 19th District
Bill Owens (202) 225-4611 (315) 782-3150 NY 23rd District
James Matheson Toll-Free Number 1 (877) 677-9743 (202) 225-3011Mike Arcuri (202)225-3665 (315)793-8146 NY 24th District
Dan Maffei (202) 225-3701 (315) 423-5657 NY 25th District
Earl Pomeroy (202) 225-2611 (701) 224-0355 ND At-Large District
Steven Driehaus (202) 225-2216 (513) 684-2723 OH 1st District
Mary Jo Kilroy (202) 225-2015 (614) 294-2196 OH 15th District
Zach Space (202) 225-6265 (330) 364-4300 OH 18th District
Kathy Dahlkemper (202) 225-5406 (814) 456-2038 PA 3rd District
Patrick Murphy (202) 225-4276 (215) 826-1963 PA 8th District
Christopher Carney (202) 225-3731 (570) 585-9988 PA 10th District
Paul Kanjorski (202) 225-6511 (570) 825-2200 PA 11th District
John Spratt (202) 225-5501 (803)327-1114 SC 5th District
Tom Perriello (202) 225-4711 (276) 656-2291 VA 5th District
Alan Mollohan (202) 225-4172 (304) 623-4422 WVA 1st District
Nick Rahall (202) 225-3452 (304) 252-5000 WVA 3rd District
Steve Kagen (202) 225-5665 (920) 437-1954 WI 8th District
Bart Stupak (202) 225 4735 MI (MAYBE)
Brian Baird (202) 225-3536, Vancouver, (360) 695-6292. Olympia, (360) 352-9768, (MAYBE)
senator mark begich (202) 224-3004 toll free. (877) 501 - 6275 just became a MAYBE
Jason Altmire 202-225-2565, Aliquippa, 724-378-0928,
Natrona Heights, 724-226-1304 (MAYBE)
On the Bubble (Major developments from the yes and no columns in the House)
Congressional Dems on Twitter
And here are toll-free numbers we can use to call any Senators or Reps.
At the first number below you must wait through a tape recording urging you to tell your Rep or Senator to vote yes for the health care bill. Just hang on and when the recording is over, you will get the Capitol operator. Just ask for your Rep or Senators office. Then you will either talk to an aid or have the chance to leave a message for him/her to vote NO on the health care bill.
When you use the second number and the Capitol operator comes on, just ask for your Rep or Senators office. Every time I use this number I get the Rep or Senators answer machine, so it may be set up that way all the time...to go to their answer machine. Either way you can leave a message to vote NO on the health care bill!
We need to use these toll free numbers that have been set up for the health care/ BO supporters and illegals to use! After all they are FREE!
1-800-828-0498 , 1-866-220-0044, 1-866-338-1015, 877-851-6437, 877-210-5351
The main question on everyone’s mind is, why do electronics even *need* health care?
There’s an Open Source EHR package available for d/l, BTW.
"If the government and insurance companies have full control of health-related data and every aspect of health care, patients' privacy will be a thing of the past."
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