The Massive EHR Evaluation and Report
The Pew Charitable Trusts, MedStar Health’s National Center for Human Factors in Healthcare in Washington, D.C., and the American Medical Association released a report outlining ways to improve EHR safety and usability. Here it is:
- Encourage a culture of safety that prioritizes optimizing EHR systems to mitigate usability and safety hazards
- Support design and development of an EHR product that prioritizes usability for end-users like clinicians
- Identify the appropriate EHR product to meet healthcare providers’ needs
- Customize the EHR with tailored coding and configuration to meet the specific needs of the healthcare organization acquiring the product
- Implement and maintain a safe and usable EHR product through regular system upgrades
- Train clinicians and other end-users to safely and effectively use the EHR product
Here are my thoughts. I don’t even know what number 1 means. Numbers two and three can be combined into one as in: Make sure the f#cking thing works. The fourth one is code for “make sure this thing optimizes billing because that is all we care about”. Number 5 and 6 really is the same as numbers two and three: Make sure the f#cking thing works”. Got it?
Let’s do the George Carlin trick and really tighten this up. This whole, massive piece of crap can be condensed into:
Make sure the EHR f#cking works but, more importantly, is able to optimize billing to satisfy the government and insurance companies.
Useless, utterly useless. How much do you think this report cost? How many meetings in nice hotels did the big wigs have to get these commandments? The patient, computer and doctor walk into a room and the only one that anyone cares about being satisfied is the damn computer!
When I deal with AtlasMD as my EHR for my DPC clinic it has been an absolute pleasure. The guy behind it, Josh Umbehr MD, is a practicing DPC doc. They get back to me instantly. It has never crashed in 5 years. I only use SOAP notes now and no extra fluff in my notes. No one is selling patients data on the back end. No one is selling my data on the back end. It works and it bills patients directly.
How about Pew, Medstar and the AMA take a look at them?
Enjoy our humor? Get Dr. Farrago’s Diary of a Drug Rep here and laugh some more.
Epic et al sell EMRs.
Hospital corporations buy EMRs.
What’s the problem?
To deconstruct the message, it is unquestionable, even unthinkable to have the clinical examination room exist without a certain machine. It is called a safety-monitoring machine, preventing bad decisions and rating the humans in their frequency of bad decisions, which are determined to be unsafe.
My organization looks up a patient’s creatinine, and medicines which merit alteration in prescribing for patients with renal disease. It then sends out a letter in my name, stating that these medicines are unsafe due to renal disease, and that the patient should speak to their doctor (who is the supposed author of the letter.)
Sometimes patients infer from the letter that they should stop the medicine. If they do so and take sick, it is attributed to “provider error,” i.e. the original prescription.
To a non-physician, this might seem sensible. To an experienced provider, it is horrifying.
As Charlie Brown would say:
ARRRRRRGH!!!
It’s essential to realize that AtlasMD is an electronic medical record, sold to physicians, almost everything else are charge capture systems disguised as EMR’s sold to administrators. Forcing physicians to ignore patients to focus on meaningless use in order to get better reimbursement.
Those of use for whom “patients first” is more than a marketing slogan, need to continue to push back against this industrialization of our profession.
If I were not 11 days short of entering my eighth decade I would I would jump on DPC.
It seems to me that every “suit” is eager to use catch phrases that make them look hip and “with it”, like, “let’s think outside the box…..”. I tried once and got shut down and laughed at. I said, “maybe, as much as we’d like to think they are cutting age, computers are not ready for prime time in the main ED. They just don’t help me at the bed side. If anything it interfers, distracts me, and slows me down”(1993). Well I was called computer illiterate, paranoid with poor typing skills…. Even at the very beginning, the argument wasn’t patient care it was billing. “The better the revenues for the hospital the better our pay and job security”. Protect the contract…was our mantra. I was reminded that I was an employed team member and that there were plenty of docs (groups) that would take over in a heart beat. I had the antiquated notion that doctors were self employed. Physicians were selling their practices left and right. “Oh the lure of easy money….”(Miami Vice)
Looks like we’re still trying to think outside the same box.
Lewis Black would say, “Just make them work!!! Just make them work for the doctors and nurses and patients who NEED them to WORK!”
To document and communicate the medical record. PERIOD.
the “junior data collection” adventure.
Precious. Think tanks gonna (pretend to) think. Pandering to their clients.
Yup, Pay me a million dollars and I’ll tell you anything you want to hear!!