Krauthammer…
…on how the requirement for keeping electronic health records is driving doctors away from the practice of medicine.
I’ve heard this complaint myself from doctors I know. Ah, but bureaucrats know best in our brave new world.
The New Neo
A blog about political change, among other things
It should be added that electronic records drive MDs away from medicine IF THEY USE THEM.
My old doc was tied up on her computer something amazing.
She ended up being an appendage to the PROGRAM.
The HMO INSISTED that ALL of the blanks be ticked off subsequent to each patient visit.
Hence, the ‘system’ is de facto run by the ATTORNEYS.
The priority is to dot i’s cross t’s and to throttle mal-practice lawsuits… the ONE metric that attorneys can really dial into.
The coding does NOT permit the doctor to just skip by and post free hand. The HMO management wants, nee demands, that the magic boxes be ticked off.
Windows programs/ mouse driven forms are not at ALL that fast — in practice — because the coders end up listing practically ENDLESS selections in the scroll-selection windows.
So, the doctor ends up spending far more time than you might ever imagine scrolling up and down to find, then click, the digital pigeon-hole that the digital masters have augered for us.
This digital burden would seem to have NO natural limits.
Ponder on THAT.
Doctors are whining babies.
Did they think that in the Age of Data, EHR (electronic health records) were not going to become important?
And if the maintenance is an onerous burden, why have their lobbying organizations (read: clubs) not got involved in making the software easier to use?
Doctors are greed-freaks who want to play golf 4 days a week, spend as little time with patients in mind and still get paid a small fortune.
Screw them.
Paul: What color is the sky in your world?
paul abarge, i think you did not bother to read…
the issue is the same as with any social left action or movement… women entering the workforce in and of itself is not bad, every woman entering the work force at once is another thing – making such a movement destructive
drinking 8 glasses of water a day is not bad, drinking a gallon all at once will kill you (but you will get high first)
mandates force them to spend a lot of their money on something that does not help them or the patient, but is mostly in place because the state pays and has to investigate everyone as a criminal, and want to use software like credit card companies do to find fraud.
the idea that it will find deseases is erroneous as they dont even understand how the systems they work on actally behave or what part is the thing, and what parts effects are due to the system being a system…
i know…
i work in research computing in one of the worlds most presigious medical schools…
oh. and your so VERY wrong with your assertion about golf…
make like harvey bristol creme and throw away those leftist boilerplates of bs… you seem to be mistaking them for news.
Donald Trump Wages War on Fox’s ‘Dummy’ Charles Krauthammer
http://www.mediaite.com/tv/donald-trump-wages-war-on-foxs-dummy-charles-krauthammer/
Standardized electronic medical records for the transfer of information between practices is a great idea. So is a central clearinghouse where you can comparatively shop for health insurance.
Either of those could have made someone a nice bit of money and provided a great user experience if they had developed organically, shaped by the market.
It’s okay. Everyone knows we have a huge surplus of doctors. IN NO WAY WILL THIS RESULT IN SHORTAGES.
One of the stated goals of EMR was to allow physicians to see research data/studies at Cleveland Clinic, Mayo Clinic, and patient records at the hospital/clinic down the street. If that were so, the first criteria for software coders writing EMR programs would be a common communications protocol. There is no such thing. The only visible goal is to gather statistical data for the feds.
There was an incentive program to help offset the costs of incorporating EMR into ones practice, and I had complied with all except one requirement – I was not handing my patients a summary as they exited the office.
Keep in mind this is all on the honor system. I could have clicked ‘yes’ that I was doing this and gotten my incentive money – but I’d rather sleep at night. Does anyone think there was no cheating in this program? So now the government has a bunch of fake/inaccurate data from which to create health policy. What could possibly go wrong?
More than one EMR program has an indicator which lets the physician know what level visit can be billed. (The higher the level, more can be charged.) Keep clicking buttons and watch the thermometer rise to whatever level you like.
Combine the ease of over-coding when using these EMRs and the pressure on physicians to ‘produce’ when in the employ of a hospital/clinic/corporate entity – well, you get the picture.
Most of the MDs I know are Obama voters.
I blame the doctors.
Coming October 1, 2015 is ICD-10. Been in private practice nearly 30 years and using ICD-9 diagnosis codes the whole time. Not only is it a whole new series of codes, it’s an entirely different way to code. From about 11k codes to 73k and counting – there are at least 45 different ways to code an ankle sprain in the new system.
The consultants we heard not long ago were advising clients they will need 3 months of operating capital (or line of credit for same) during the transition as no one will be getting paid while insurance companies, government entities, physicians and hospitals sort it all out. They have revisited their estimates and now instruct their clients to have six months operating capital handy.
Reimbursements are declining, costs are rising, and the paperwork / compliance requirements are becoming ever more burdensome.
Supposedly all of this (EMR, ACA, etc) was going to reduce costs to the health care system. But what has spawned are entire new careers in health care which have absolutely nothing to do with making patients better. Scribes, coders, compliance officers are all now CAREERS. These folks have to be trained and expect to be paid for tasks which exist largely to do nothing more than comply with mandates.
…Oh yeah – ignore Paul the troll.
I have been to doctor’s appointments and while I am describing my status, symptoms, etc., the doctor types, types, types, never looks up, and types some more. This is after I have been through all this with the nurse a few minutes before. I don’t know whether or not the doctor is listening or trying to find the correct field in which to enter data. That and the little eye contact is disconcerting. I am about to change doctors, but have little hope that it would be a better experience.
My recent experience with EMRs is that we need to be familiar with our records and be able to provide a relevant top-line summary to the Doc or the Tech. Many EMRs are stratified by source – nurses, doctors, techs, etc. – and one guild will not read what the others produce.
I know doctors hate it when you go in with a list or with paper, but with the problematic nature of EMRs this will be necessary to avoid a lot of ignorant questions and activities. This situation cries out for some sort of AI so that the EMR produces a report that is relevant to the visit or procedure at hand. Nothing like that is on offer right now, so being well informed and effective in summarizing one’s own condition is essential to effective care.
Centralized electronic health records. These weren’t developed to help a doctor and their patients. It was developed from the top, and sent to the bottom so the lackeys can obey their orders and collect information on domestic violence and gun ownership.
As a nurse, I have seen electronic charting, in various forms, come and go.It is not just the charting, though. Thirty years ago, we got IV pumps that would regulate the flow rate, etc, using a lot of little transistors. BUT, the damned things would set off alarms all the time, “line blocked” for example, when it was not, and the infusion would stop, Eventually, the hospitals abandoned the pumps, and we went back to timing the drips the way we learned in school, drops per minute, multiplied, with even a handy note on the bag or bottle to remind us of the drops to cc/hr conversion. Of course, the gadgets are designed by gadget engineers, who never saw a living patient, so the “interface” with the nurse was faulty.
Of course, we do the same thing now, only on paper, so the care plan is five or six pages, small print, with eighty percent of the data completely irrelevant to the actual needs of the patient. Likewise, we check a great many boxes, to prove we were providing good patient care, taking time away from the patient, which is where we provide, oh, yeah, good patient care.
AND, the charting is intentionally dense, to inhibit real communication, because anything we say might possibly be used as evidence against us in a lawsuit.
As for Doctors’ incomes, their actual take-home, depending upon the specialty, of course, is a little less than that of software engineers.
Oh, yes, my doctors absolutely love for me to bring a written summary to an office visit.
So the lawyers get rich from doctor malpractice. The insurance agencies get rich from it. And the unions get rich from making more lawsuits for lawyers. It’s like a nice mafia circle almost.
This isn’t a difficult thing to overcome. Everytime i go to see a new doctor, I’m handed a clipboard and a stack of crap to fill out. Then somebody enters it into a computer. Or maybe they don’t, but either way, hand me an Ipad or some other tablet with the forms on it, and let me fill it in for the doctor. Most of information could be entered by the patient, to the database that they’re using via a WiFi/web connected tablet. The doctor or his staff could fill in whatever the patient can’t.
I hope doctors aren’t really so tech illiterate or unimaginative that they can’t figure out something along these lines.
Starlord…
You’re talking about somebody’s rice bowl.
Sheesh…
It’s the MOST difficult thing to overcome.
Y @ 4:48 – –
Centralized electronic health records. These weren’t developed to help a doctor and their patients. It was developed from the top, and sent to the bottom so the lackeys can obey their orders and collect information on domestic violence and gun ownership.
Understandably but absurdly the leftist agenda has infiltrated. It never is what it purports to be.
For all the talking about how the German people let it happen, we are letting it and probably have let it happen.
The will has triumphed, the will to impose nonsense on a compliant populace.
That nonsense is very clever and cunning does not make it less triumphal.
And human nature wants to be he winner.
1. Mongrel. You are so correct. Three months of capital to get through the transition. Cui bono? Well capitalized corporate practices mostly owned by hospitals.
2, A big software company in Madison (Elite) has this EMR contract. Big Dem contributors.
3. Doctors’ incomes are shrinking and many are quitting. Doctors save lives. Software people code. They make the same money. Talk about income inequality.
4. If the ACA isn’t kicked this month, we are completely screwed.
In theory the electronic health records are a good thing. In my lifetime I have interacted with many doctors and several hospitals in very diverse geographic locations. My medical record with my present doctor consists of a brief summary of all my previous maladies and the doctors who attended to my care. (If I can remember them.) Thus, what my present doctor really knows about me dates back ten years to when I began seeing him. Theoretically the EMR would give him a much better picture of my medical history, and it would be available in short order to any doctor treating me in a far away country when I’m traveling.
However, it’s obvious that the EMR has become a tool of bureaucracy to meet their requirements, not those of the doctor – patient relationship. The unintended consequences of what seemed a good idea that has turned into a bureaucratic nightmare.
EMR is very useful for transmitting images (radiology studies) instead of radiologic language, and for transmitting other data (lab, audiometry , etc) but it is pretty useless for the sharing of patient history and physical findings since those are not used by the imagers and laboratories, so with whom are they to be productively shared (as opposed to a doc to doc phone call which more quickly gets into the nuances of a) the problem, and b) its solution
The rest is just so much digital noise; it adds little, takes time and is often wrong! Radiology and lab care not what meds the pt is on.
So EMRs generate a lot of chaff with the wheat AND THEY TAKE TIME TO GENERATE. THAT’S TIME NOT FOCUSED ON THE PATIENT AND HIS PROBLEM.
tHE SAGA OF INSTITUTION VS PHYSICIAN CONTINUES UNABATED.tHE EMRS ARE ALL DOC-UNFRIENDLY, SO PRODUCTIVITY FALLS WHILE OVERHEAD RISES. WE ARE DOC SHORT AND ARE WASTING THOSE ASSETS.
If one act epitomizes the evil of Obama, the ACA is it. It enslaves doctors under the threat of imprisonment and fine for making a mistake on a form. We truly live in a Kafka-esk reality.
Electronic health records can be useful. But it is beyond insanity for the federal government, or any government, to mandate how medicine should be practiced.
As i have aged, I find myself going to the doctor more. i settled on a GP, a member of a medical group, or system, whatever it is. She is a central clearing house basically. She sends me to various specialists within the system she is a part of. My records pop up on a computer screen in the specialist’s office. I get asked questions, things are clarified, my thoughts are inquired of. I get ten minutes in front of my GP when i go to her. She is always on a computer looking at my records, brushing up, before coming into the examination room to see why I am there. The initial visit with a specialist can last an hour. She always types into another screen in the examination room while we are together. It’s better than her scribbling on a tab and adding it later, provided she remembers to.
Long and short, I have been “unlucky” the past couple couple decades. Broken back, lung cancer, brain tumor, possible lymphoma (at the moment) and goiters in my thyroid causing all kinds of stupid things to wrestle with in my system. I have had good success with a whole bunch of doctors within this same medical system who can get a full bucket full of medical history on me by pushing “enter”. Perhaps it is just the system I am in. I know my company, and I, pay a handsome sum for my health insurance. Because of this particular system, and the people involved, I still possess my rugged good looks, boyish charm, and naturally curly hair. It is my belief Obamacare will destroy it as soon as possible.
A Democrat said this during the run up to the elections on 2008. It said that they were going to vote Democrat because Democrats are not the party of corruption, that there is a lot more corruption amongst Republicans.
For them, the more corruption deals they take in, the more they have to find someone else to blame, like blaming Sarah Palin as an example.
br549 i wish you the best of luck and god be with you.. 🙂