Locked-in

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This is from the AMA Morning Rounds:

Politico (9/15, Pittman) reports in “Morning eHealth” that the American Medical Association is “circulating a sign-on letter asking HHS to ‘pause’ finalizing meaningful use Stage 3 rules while the government reevaluates the EHR incentive program.” The letter states that “moving forward with MU Stage 3 at this time will severely undermine the ability of the health system to support the implementation” of this spring’s SGR-repeal legislation. Additionally, the AMA said that if the Stage 3 rules are finalized now, “vendors will create software that will lock-in problematic technology, which physicians and patients will be living with for years to come.”

Locked-in problematic technology?  I have not seen that term used before but it is awesome. One could say that the whole concept of EHR/EMRs as they relate to patient care (not billing) is locked-in problematic technology.

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] 

  7 comments for “Locked-in

  1. Sir Hakum of Hugo
    September 16, 2015 at 5:28 pm

    “They suggested primary care practices establish each patient’s agenda before the appointment to help determine in advance how much time will be needed for the visit”.

    The true agenda is never presented until the physician walks in the room.

    EHRs are not designed with the end user in mind. It is a data collection device for insurance companies, the government, and for administrators trying to measure “Quality”.

    Are we allowed to utilize Enhanced Interrogation Techniques like waterboarding to ferret out the true “agenda”? Is there a CPT code for that?

    • Steve O'
      September 21, 2015 at 5:14 am

      Patients are not acting like widgets, and somebody must be punished. “Quality” is defined as an eraser for the payment statement. So what’s new?

  2. Gayle Mosher MD
    September 16, 2015 at 11:14 am

    I do love my ongoing chronic overuse thumb pain from clicking, clicking, clicking just to get through the most mundane of EHR tasks. Problematic technology is just one symptom. Can hardly wait for the worsening tendonitis coming along with ICD-10.

  3. Perry
    September 16, 2015 at 8:38 am

    Well, despite what happens with Stage 3 MU, the SGR repeal is not going to be much better for docs in the long run, and will continue to be tied to ridiculous documentation and “quality” schemes.

    • Perry
      September 16, 2015 at 12:58 pm
      • R Watkins
        September 16, 2015 at 3:17 pm

        From the above article:

        “PCPs are expected to manage and treat a patient for what has happened since their last visit during a 15- to 60-minute consultation, when many times, patients are unorganized or unprepared”

        Yeah, those unorganized 60 minute consultations are really a big problem for most family physicians.

        What planet are these people on?

        • Steve O'
          September 21, 2015 at 5:32 am

          These great theorists have come up with the solution – see the patient for five minutes, and then “Send Them To The ER.” I tried to get one or two admitted directly to the hospital, and there’s a waste of time! The primary care system is just becoming a preliminary step for sending the patient to the ER. IF you want to build a “cost-no-object” system that wastes money, couldn’t beat that.
          I’ve seen patients sent off to the ER on the basis of a (colleague) reading the EKG Idiot Box printing out “cannot rule out MI.” The (colleague) sends them, ‘nothing is wrong’ and they come back to me with their mild clinical hyperthyroidism. What a money-saver! NOT.

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