The Era of Electronic Medical Records

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The rise of EMR's is a very good thing. The key however is user adoption and experience. If docs and clinical providers do not want to use an EMR, then the impact is minimal. The era of poor designed systems must come to an end and the rise of truly user friendly EMR's must happen.
I found this site that focuses on comparing the UX of EMR's. You can tell where the real disparities exist: http://emr-matrix.org/

Adam Scott of WA 10:11AM November 30, 2012

I have filled four different electronic medical history forms and not one of them permitted me to accurately describe my medical history and condition. They were series of yes/no questions listing the most common diseases Americans have. There was no way to report rare or unusual diagnoses such as mine. I have written to the National Organization Rare Diseases about this; apparently they no interest in helping solve this problem. In future I will refuse to fill out these forms and I have suggested to other people with mast cell diseases to boycott them as well

Marti Wolfe of CA 9:45PM November 12, 2012

Dave, you seem very enthusiastic about the EHR systems, and fact that CMS is offering generous subsidies.
You seem less concerned with quality - it is the same GIGO that has plagued computer systems for years.
I have submitted my medication list to our local hospital at least four times. I have it on Excel, neat and complete. No EHR that I have ever seen has the capability to upload computer records from patients - a staff person has to sit there and laboriously enter them by hand EVERY TIME I VISIT THE HOSPITAL! Last week was for emergency surgery,, the surgeon said, "Where are her medication records?" My husband said he would email them, they acted like email was something from another planet - he had to fax them and the hospital could not transmit them from the ER to the surgery ward. Everything they tried to give was wrong - in the end my husband had to smuggle my meds in to me. And my discharge papers said my meds "could not be verified".

Marti Wolfe of CA 9:42PM November 12, 2012

I have filled four different electronic medical history forms and not one of them permitted me to accurately describe my medical history and condition. They were series of yes/no questions listing the most common diseases Americans have. There was no way to report rare or unusual diagnoses such as mine. I have written to the National Organization Rare Diseases about this; apparently they no interest in helping solve this problem. In future I will refuse to fill out these forms and I have suggested to other people with mast cell diseases to boycott them as well

Marti Wolfe of CA 9:02PM November 12, 2012

Electronic Medical Records (EMR) in Chicago for Practice Readiness, Training & Technical Support to help your organization achieve successful EMR/EHR implementation, has been the sole focus of Technical Dr. Inc Since 2007 - http://www.technicaldr.com/tdr/electronic-media-records-chicago

nitu of IL 5:56AM October 31, 2012

The system the US has set up is in no way beneficial to the citizens of our country. This is just one way for a bunch of corporations to make money fighting to see who gets the contracts. Let me expand on this. I started in the healthcare industry as a paramedic in 1999. My system had already started using EMR and the backup paper records in case the system failed. When I went to an office based system in 2005, they were just implementing their new EMR/EHRs system.
I have watched this expand, and not only does this decrease care by the physician, it does not allow you to access records from other sources that have purchased other systems. I am also watching a lot of good doctors retire to get out of the US quagmire, and others emmigrate to Canada and New Zealand. They are required to spend more time clicking buttons to meet Meaningful Use than spend time with the patients. It also requires them to see more patients to keep up with the demand. Our system pays for quantity, not quality. Plus, we do not value the worth of a primary care doctor here. So in the end, it is the clinical staff performing half the electronic work for the doctors. The MU requirements are quite tedious. If the patient does not require the standard of care, in some cases you must document this every visit. Again, waste of time and resources. Yes, CMS will give you a bonus as stated above. However, they left out the info that this bonus decreases over a 5 year period, and those poor docs that do not/cannot spend the money on this farce start getting penalized every year there after. It used to be we paid one person in our medical records department. The team for our small group of docs includes one supervisor, four full time, and one part time IT employees.
Here is another point I want to add. There is no reliable centralized EMR in our country, except for the VA. This is another way that EMR/EHR will not work in this country. I hear that is changing, but not at a rate that anyone really needs them to. Capitalism got in the way of common sense here. The government tauts that it will help improve the accessability of EHR from other docs across the country in a perfect world. Yup, the only place I have seen this come to fruition is the VA when I take my Dad, and the countries that have socialized medicine. The VA uses quite a similar system as Canada.
As usual, this decision was a knee jerk reaction by our government. So far, I am not seeing the savings. I live in a state with a large seasonal population. We have patients with a PCP "up north" and tourists from all of the world. For the incountry patients it can take me weeks to get medical records from other docs. If they even send them. So in the end, we may order a duplicate test, as I have no access to that patients records. I could go on about the dismal system, but I am running out of characters.
On the hacking issue. We now have to employ an entire team of IT security folks.

V. Marinelli of FL 10:21AM October 16, 2012

Electronic Medical Records are the basis of the Meaningful Use discussion prevalent in Healthcare IT: http://www.technicaldr.com/tdr/ehr-selection

Mitu of IN 7:10AM August 21, 2012

Electronic Medical Records deliver time, productivity and cost benefits across the practice in the long run: http://www.technicaldr.com/tdr/ehr-selection

mitu of IN 5:12AM June 05, 2012

A month ago, HHS awarded consulting firm KPMG with a $9.2 million contract to develop the protocols and conduct the HIPAA audits of hospitals and providers (including HIPAA-covered dentists). 150 are to be performed by the end of 2012. What’s more, audits no longer have to be triggered by a complaint - although a disgruntled worker or patient can always increase a dentist’s odds of a site visit by a KPMG auditor working on commission and having a bad morning.
“Site visits conducted as part of every audit would include interviews with leadership (e.g., CIO, Privacy Officer, legal counsel, health information management/medical records director); examination of physical features and operations; consistency of process to policy, observation of compliance with regulatory requirements.” - OCR HIPAA Audit Protocol and Program Performance, June 20, 2011.
https://www.fbo.gov/index?s=opportunity&mode=form&id=9e045aa4f7e6f8499c5b6f74d5b211e9&tab=core&_cview=0
That hardly sounds like fun I want to buy into.
HHS stresses that an emphasis will be on enforcing “a culture of compliance.” Translation: Dentists, before an ambitious KPMG inspector with fuzzy teeth pisses you off with questions that obviously have nothing to do with dental care, be alert for other signs in the shared atmosphere that someone in the room probably dislikes you.
Even in an otherwise free society, nobody can defend against accusations supported by subjectivity such as “a culture of compliance.” So dentists who find themselves in this unfortunate position should be especially respectful to KPMG auditors or risk being capriciously accused of “willful neglect” - which carries the highest HIPAA fines. In addition, one wouldn’t want to attract the attention of their state’s attorney general. According to HITECH, they have the right to file lawsuits for HIPAA violations as well. As a group, State AGs aren’t known to have a sense of humor. And like KPMG auditors, one or more might simply dislike dentists to begin with.
It’s my hope that eventually, someone will come up with dental software that will circumvent HIPAA by not allowing patients’ Protected Health Information (PHI) to be downloaded. Until that tricky string of coding can be figured out, interoperable EDRs simply will not happen because patients won’t accept EDRs’ danger over paper dental records.
D. Kellus Pruitt DDS

Darrell Pruitt of TX 5:09PM July 22, 2011

In regards to the initial cost and challenges associated with implementing an EHR newer cloud based SaaS EHRs go a long way to overcome theses issues. They require no new hardware and all IT issues are handled remotely (also alleviating concerns associated with compliance).
As far advantages relating to increased quality of care these results will become more obvious shortly, again due to new innovative EHR solutions adoption and use is becoming much easier and more intuitive. There are in fact several examples available as to the positive effects of EHRs in treating chronic conditions among other things.
For more on EHRs please visit: http://www.vitalhealthehr.com/blog/

Arjen Westerink of WI 12:03PM July 21, 2011