EMR Madness
It is the middle of 2016 and over half of EMRs do not talk to each other. Here is what a recent survey also showed:
- According to the survey, patient information is still not shared across providers. In fact, only 49 percent of physicians with EHRs said that they can share patients’ records electronically with clinicians outside their practice.
- Just 49 percent of consumers surveyed indicated that their physicians are able to share information about their health and know their medical history before they get to their appointment.
- Further, only 60 percent reported that their primary doctor has access to any hospital or ER visit records without them bringing them to the physician office.
- And only 63 percent of surveyed consumers said that if their doctor is not available they could see another provider who has access to their EHRs.
This is true madness and will only be corrected by lots of money. The EMR companies aren’t going to pay it. So, then, who is going to pay for?
Any true innovation that will improve a business or industry will be discovered and adopted by the free market. By definition, the fact that these damn systems were forced by government meant that they wouldn’t be the best solution.
The infuriating shame is seeing all of my colleagues who believe in supporting and strengthening Medicare and Medicaid, yet complain about theses systems and their expense, and cannot comprehend how this support also allowed the abuses by corporate insurance. YOU asked for this, so enjoy it.
The stupidity is the idea that if we transition into a “data rich” environment, it will make things go better than a “data poor” environment.
The old-fashioned telephone is an inefficient way to stream tons of data. When doctors discharged inpatients from the hospital, the transfer of data was terse but sufficient: “Charlie came in with a bad belly, and it was appendicitis, so we did an appendectomy, and his course was uneventful.” Actually, in the old days, the PCP would SEE the patient once in the hospital before discharge, usually. But the “data-poor” environment we learned to scoff at was actually better for the patient.
Now, they come in with discharge instructions, which are fifteen pages and barely mention the presenting complaint. You can read about patient’s grandmother’s bunion, and whether she wears seatbelts. More is better, but only in the minds of those who manufacture EMR’s. Bells, whistles – and whistles that ring bells, that’s the ticket.
I sent a patient to the ER for melena on Friday afternoon. She was discharged Monday night with a diagnosis and workup of community-acquired viral syndrome (i.e. the message never got through.) When I called her to find this out Monday, I told her to come in on Tuesday. She no-showed, on account of being dead. From a GI bleed.
Nowadays, that’s nobody’s fault, what ya gonna do? They’re too busy chasing whether a patient received an injection via a 23gauge needle, when the nurse INSTEAD documented a 22ga. needle! Which one’s the medical error in the Quality Review Committee – wrong needle, or being dead?
I just don’t get this obsession with “interoperability.” Why in the world would I want access to thousands of pages of useless templated EMR garbage from other institutions? Why not continue to do as I’ve always done – i.e., have my well-trained staff get any relevant information faxed over before I see the patient?
Right. If interoperability means reams of useless crap, I don’t need it. I end up scrapping well over half of what I get from the medical records dept. Which points out another feature of EMRs the way they are set up. How much of this information is really useful to caregivers? Clue: very little.