Regulatory Requirements Drive Dissatisfaction

The title of this piece is called “Regulatory Requirements Drive Dissatisfaction With EHR” and the first thing I thought to myself was “really”?  Isn’t that obvious by now?  Doesn’t everyone know this?  It’s like stating that “water found to be wet” or “pregnant women more likely to give birth than non pregnant women”. Regulatory requirements = bureaucratic drag which burns us out.  End of story.

This article is actually about the May 8th piece in the Annals of Internal Medicine where “N. Lance Downing, M.D., from the Stanford University School of Medicine in California, and colleagues discuss problems with EHR systems”.   Goody for them.  Here is a summary:

  • The authors note that physicians abroad who have adopted the same vendor software as that used in the United States were more likely to report satisfaction with EHR use and cite it as a tool that improved efficiency.
  • The EHR tends to be much briefer in other countries, containing only essential clinical information and omitting much of the compliance and reimbursement documentation.
  • Clinical notes are nearly four times longer in the United States than in other countries, across the same EHR.
  • Physicians are required to document an increasing amount of low-value administrative data; these documentation requirements are the remnant of the fee-for-service system.
  • However, meaningful-use incentives have created more requirements for low-value documentation, and value-based models have their own documentation requirements.
  • Simplifying the regulations around documentation and billing would likely benefit the health care system and patients.

Are you kidding me?  These “geniuses” just repeat what we doctors have been saying for years! But it’s not about simplifying regulations. It’s about getting rid of the middlemen who are judging us via the EMRs; that being insurers and the government.  Get them out of healthcare and let us do our job.  Boop.

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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] 

  4 comments for “Regulatory Requirements Drive Dissatisfaction

  1. Aaron M. Levine, MD
    May 16, 2018 at 9:45 am

    The Atlantic just did an article on physician shortage and burn out. Guess what, the EHR andMOC are issues they feel need correction.

    I spoke with a urologist. His group uses a GU oriented EHR. Apparently there were two leading products, both bought by the same company. The company is closing out the larger selling one forcing the urologists to now buy the second largest one. Sales are up. Also There is an extra soft ware (at a modest cost) allowing the older records to be transferred to the new format.

  2. Jralph
    May 16, 2018 at 9:12 am

    What ever happened to “user friendly” ? I have used these systems for over 20 years and NEVER recall anybody asking for user input on their HS [H stands for horse] EHRs. It is pathetic that “health thought leaders” really think hiring scribes to deal with bad systems is somehow a logical way to restore productivity.

  3. Perry
    May 15, 2018 at 7:57 am

    “Physicians are required to document an increasing amount of low-value administrative data; these documentation requirements are the remnant of the fee-for-service system.”

    I call BS on that. They always want to blame to FFS system.

    • Jennifer Hollywood
      May 15, 2018 at 8:31 am

      Agree. These are not part of the FFS system. They are part of the value based care BS that is getting pushed through by insurers and the government. We were doing FFS since the beginning of time. A patient came and paid for their services. That is FFS. No one asked for this extra documentation until value based care came into vogue. These extra clicks provide no benefit to the patient and their health, other physicians reviewing records, or myself in regards to managing the patient’s care. They clog up notes with useless data, are often collected and reported by non-clinical personnel, and do not influence or change what most doctors are doing. We have been providing the appropriate services for years. Now we just have to click a bunch of buttons to prove it. Even if it is documented in text form, the computers don’t see it so therefore it’s like it was never done.

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