Electronic Medical Records and You

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Did you know that “Multispecialty physician practices spent an average of $20,693 per full-time-equivalent doctor in 2014, a 12% increase from the year before and a 34% increase from 2010 to try to keep up with the federal electronic health-record requirements”.  Many of you who read this know that the EMR does not really help patient care.  In fact, it impedes it.  You spend most of your time clicking on useless metric boxes.  You stare at the damn screen trying to find the right information.  After a while, you hate the thing. Of course, the business people who supposedly run healthcare understand that, right?  Well, here is Dr. Halee Fischer-Wright, CEO of MGMA, to offer her opinion:

“The way patients ask for and receive care is changing. The increased use of technology can improve the quality of patient care by improving records management, optimizing workflow and meeting HIPAA compliancy requirements.”

Improve the quality of patient care?  How?  Does anyone out there think that improving records management, optimizing workflow and meeting HIPAA compliancy requirements makes your visit with a patient better?  Sure, you can debate that better records and better workflow allows you to see more patients but there is no proof you are giving a higher quality of care.  You see, these administrators just don’t get it.  What is “it”?  Well, it is that moving target called “quality”.  The way doctors define it, which is more in line with the way patients define it, is lightyears apart from how insurance companies, the government and the administrators define it. The way they define rhymes with shmore shmunny.  And Halee Fischer-Wright is a pediatrician.  You think she would know?  Alas, that is what happens to every doctor who turns to the dark side.

 

 

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  6 comments for “Electronic Medical Records and You

  1. mamadoc
    September 30, 2015 at 8:46 pm

    Improvement and efficiency my backside. Bottom line: I will NEVER as efficient with the *(&EMR and I was on paper, nor will I be able to find things (like labs etc) as easily as I did in our very well organized paper charts. And making us put all the information on an electronic system that can apparently be hacked at will doesn’t make me more HIPPPA compliant. With paper records you just turn out the light and lock the door. Retirement is looking better all the time.

  2. JoAnn
    September 30, 2015 at 8:13 am

    The long and short-in our office, the only person who likes EHR is the billing clerk. That tells me all I need to know about the usefulness of EHR in healthcare.

  3. Steve O'
    September 27, 2015 at 11:10 am

    I can’t leave off this thread regarding Orwellian language in the future of medicine, without a fine example just published, of course, in the literature.
    Several of our thought leaders have been puzzled by the term “conflict of interest.”

    The term “conflict of interest” is pejorative, confrontational, and improperly implies that there has been inappropriate behavior. A better term would be confluence of interest, which considers that the potential for bias can extend to departments, research institutes, universities, and nonprofit funders (such as the National Institutes of Health and foundations), as well as to journals that might generate advertising revenue from sponsors.

    Cappola AR, FitzGerald GA. Confluence, not conflict of interest: Name change necessary. JAMA, Sept 24, 2015
    The principle of conflict of interest leads to all sorts of wrongthink, and is Oldspeak. Our Leaders such as Dr. Halee Fischer-Wright are close to the center of the – Hive Mind, as it were – and are multiconnected with many influential elements to the brave vision of the future. They have a greater and more far ranging set of interests than the local MD – they should be seen as a great nexus of all sources, a confluence of brilliance, rather than some arrogant nobody whose back is well rubbed, some moocher getting fat off being a mouthpiece. They deserve admiration – they will have admiration, by God!

  4. Steve O'
    September 27, 2015 at 10:33 am

    There are a number of important methods of suppressing a free society. We thank Halee Fisher-Wright for demonstrating a few for us.
    “The way patients ask for and receive care is changing.” Here is contempt. One of the duties of people in authority and power is to patiently explain reality to the peasants.
    The flip side of contempt is doubt. If you do not believe that you can tell, well, shit from Shinola, then you are a perfect physician of the new millennium.
    The greatest heresy is to say – “Well, that’s not what I see in clinic.” Those are attitudes relating to a seditious mind.
    With the EMR, we are being told, in a sense, that “Cyanide is a regenerative drug when given to people over 85 years old.” For us to say that such a statement is a lie, and wicked lie at that, marks us as ‘outliers.’
    The increased use of technology can improve the quality of patient care by improving records management, optimizing workflow and meeting HIPAA compliancy requirements.”
    “Quality” is that which you aspire to, something for which you are commended and praised, something which you cannot grasp but must be told to you by someone in authority.
    Joseph Weisenbaum, a computer scientist warned fifty years ago about “Imperial Reasoning,” I believe the phrase went. They tell you what to think about, and you use your own God-given abilities to further their cause. You may not select the things to be worked on, any more than you may select the candidates for whom you might vote. They will select them; perhaps they will allow you to choose from among them.
    Physicians have existed for millennia, and so have records management and optimizing workflow. The HIPAA compliancy god comes strictly from the religion of bureaucracy; it is new to the pantheon. If the goal of medicine is the healing of the sick and ministering to the dying, and the physician insists of primacy of experience in these matters based on training and education, then we have the healthcare system that has gone on in most of the world for most of civilization. When we allow words to mean what the leaders say they mean, that quality is the size of the yoke around your neck, then we have another thing – a dreary other thing that fortunately never lasts long.

  5. fred powell
    September 27, 2015 at 10:19 am

    Well, Doug, anyone who has to hyphenate their last name really shouldnt be listened to anyway. I mean, she cant even figure out what her surname should be.
    Yes, you and I both know, because we are or have been in the trenches, seeing patients, that clicking boxes on an EMR to avoid a penalty, actually decreases care. The patient could be hanging themselves in the corner and we’d never know, until we got all the very important boxes checked.
    That, and the newest PIA called ICD-10 pushes me closer to the door as the minutes pass.

    • Steve O'
      September 27, 2015 at 10:46 am

      It is a whirlwind of vanity, led by the most despicable for the most purposeless cause.

      “For Nietzsche, vanity is the hallmark of the meek and powerless. They cry for a good opinion of themselves–not being able to set their own value. The slave morality is subject to flattery–such persons know they do not deserve praise yet they believe it when they are praised by the master since they have not the abilities to create value. Vanity is a consequence of inferiority.” Lander, Ethics

      We are told to lick the hand that pets us. They show proudly that they do not care about “quality,” but only about their own plush chair, and the ability to make others tremble. ICD-10? I wonder if there are a hundred people in the US who “believe” that ICD-10 is useful. But as a whip for the disobedient, their mouths water. All will get better, their pride tells them, when the last of the disobedient are whipped into submission. That’s an old, old tale.

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