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What are the promises and realities of an EHR

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PMRNC:
Cumbersome is one word.. clumsy is another and adjustment is another.. but all of that is on the Practice's side. When do we hear about the privacy issues on the side of the patient? that's my whole deal.. they don't get a vote, physicians are going to be OBLIGATED to educate them and so far that's not working out too well. Patients must know their state privacy laws in addition to federal privacy rights.. I've not seen ONE physician with a hand out on privacy for the patient.

RichardP:

--- Quote from: Ango_mark03 on July 08, 2014, 05:33:23 AM ---... is it taking the time which is meant for patient visits or the error in the workflow?
--- End quote ---

A couple of our clients adopted an EHR about four years ago.  Once they got up to speed, they were spending about 30% of their workday putting data into the computer/EHR.  Much of what they were using their very expensive time to do was what we used to do for them as their Practice Management company, using much cheaper labor.  Time that they previously used to generate income with by seeing patients.  I have since read articles in Medical Journals, and the related comments, where many other EHR adopters were reporting about that same 30% of their workday - doing data input rather than seeing patients.


--- Quote from: Ango_mark03 on July 08, 2014, 05:33:23 AM ---... How about its benefits?
--- End quote ---

The Federal government has a goal to develop best practices for as many medical conditions as possible.  The changeover to using EHRs will allow them to collect the data - illness definition; treatment(s); outcome - that will allow these best practices to be discovered (what range of treatments generated the best outcomes for a given medical condition?).  In that respect, the changeover to EHRs is not for the patient's benefit, it is for the Federal government's benefit (as well as the Insurance Carriers).  EHRs are likely to result in reduced doctor/patient interaction - which cannot be to the patient's benefit.

We have discussed these issues on this board before.  If you search, you are likely to find similar comments.

rdmoore2003:

--- Quote from: PMRNC on July 08, 2014, 12:24:56 PM ---. I've not seen ONE physician with a hand out on privacy for the patient.

--- End quote ---

WE DO!!!!

kristin:
I have a bit of a dual perspective on it, because the office I run does not have an EHR, nor will it ever, and the various doctors I do remote billing for all switched to EHR's in the last few years. Believe me, my doctor is the happiest one out of the bunch. She doesn't have to deal with Meaningful Use, PQRS, E-prescribing, etc. She isn't, nor are her staff, chained to a laptop/tablet during patient visits. Her eyes are on the patient the whole time, and patients tell us how "nice" that is, compared to their other doctors with EHR's. But we are lucky...she is retiring in a few years, and when I ran the cost/benefit analysis of getting an EHR and implementing it, versus not getting incentive money, and getting dinged by Medicare down the road, we still come out ahead.

For the doctors I deal with that do have EHR's, while they like certain things about them, overall, they wish they hadn't gotten them. But they all have a good 15 years or more of practice life left, so they really didn't feel they had a choice. And most of them won't get the incentive money, due to scope of practice, and other issues. Not one of them have set up the patient portals, either.

Of the seven different EHR's/PM softwares I use for my remote billing(because of course, not one doctor happens to use the same one, LOL!), frankly, one is worse than the other....especially when it comes to actual treatment notes. The whole use of templates causes real problems, and there is no "flow" to the notes. Plus there is the EHR function of "prompting" the doctor to choose certain codes/EM levels, and that is a whole other issue. So yeah, I am not a fan.

DMK:
Love this discussion!  We've been seeing, directly, what's motivating this whole EHR movement.  Drugs, drugs, drugs. The ability for the insurance companies to see who smokes, who's fat, and who has high blood pressure and depression, so they can raise rates, drop patients or put them on drugs.

Our software actually prompts us to counsel on weight loss, smoking cessation, and test for depression.  None of it is in our scope!

We've been trying to educate the patients about their rights.  Most don't like the EHR AT ALL!

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