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I work in a hospital, went to school for Healthcare Information Technology, and I implement the systems that doctors use.
I have been in IT automating shop floors, automation distribution lines, streamlining financials since 1988. It amazed me that my doctor still wrote things down on paper. And when I got very very sick and saw 6 different specialists, each one asked the same questions, wrote them all down on paper. My pulmonary Dr., my endo, my cardiac Dr, my allergist, etc. They would not even read the testing done if I brought it. They all prescribed me meds with abandon.
Now, with EHR's, even though doctors HATE them, when the doctor prescribes a med there is automatic drug-drug, drug-allergy interaction checking. A red box pops up and warns a doctor who must then override the warning with a reason. Back before EHR's the PDR (Physician's Desk Reference) was the only option besides memory to look up possible interactions and side effects. Based on actual studies it takes a doctor 10 minutes to look up the info in the PDR. The entry into EHR is instant.
Fee for service is on the way out. Pay for performance is where healthcare is going. If your worried that your doctor is not going to take as good care of you because you refuse to comply with things like diabetes controlling behavior, then perhaps changes are in order. (That is not directed at anyone here, just a statement).
Yes, change is hard and painful, but ultimately it is needed and the US is light years behind less developed countries, thanks to our paranoia about who is watching us.
YOUR CARE IS NOT FREE!!!! You pay huge taxes for that "free" care. You just pay it before you have any care. Your taxes for your "free" care are a LOT higher than we pay for our premiums and out of pocket costs.
No its not free BUT in the UK I was paying @ 20% income tax and I got free healthcare whilst now in the US I live in Michigan so I pay state and federal tax which work out to be about the same and then I pay an extra $600 a month for health insurance which also expects me to pay a deductible and co-pay for Drs visits and medication. I know which I would rather have.
I work in a hospital, went to school for Healthcare Information Technology, and I implement the systems that doctors use.
I have been in IT automating shop floors, automation distribution lines, streamlining financials since 1988. It amazed me that my doctor still wrote things down on paper. And when I got very very sick and saw 6 different specialists, each one asked the same questions, wrote them all down on paper. My pulmonary Dr., my endo, my cardiac Dr, my allergist, etc. They would not even read the testing done if I brought it. They all prescribed me meds with abandon.
Now, with EHR's, even though doctors HATE them, when the doctor prescribes a med there is automatic drug-drug, drug-allergy interaction checking. A red box pops up and warns a doctor who must then override the warning with a reason. Back before EHR's the PDR (Physician's Desk Reference) was the only option besides memory to look up possible interactions and side effects. Based on actual studies it takes a doctor 10 minutes to look up the info in the PDR. The entry into EHR is instant.
Fee for service is on the way out. Pay for performance is where healthcare is going. If your worried that your doctor is not going to take as good care of you because you refuse to comply with things like diabetes controlling behavior, then perhaps changes are in order. (That is not directed at anyone here, just a statement).
Yes, change is hard and painful, but ultimately it is needed and the US is light years behind less developed countries, thanks to our paranoia about who is watching us.
Those drug interaction red flags sound good, but they are poorly designed. Result: they get ignored.
If doctors are only going to be paid for good outcomes, do they get to "fire" non-compliant patients? It seems to me that the unintended consequence of "pay for performance" will be doctors seeing only healthy patients. What do you do with conditions that cannot be "healed", like multiple sclerosis? How about the patient with heart disease who refuses to try a statin because of what he's read about it on the internet? People who refuse vaccines?
Pay for performance sounds good until you realize that the outcome may be driven more by the patient than by the doctor.
Doctors hate medical records because they want to take care of patients, not be unpaid data entry clerks.
I have a couple of thoughts on that. One is that healthcare is so far behind other industries that have been automated and worked out these issues that it is going to take time. The other thought is that a doctor should not be disregarding warnings because they are annoyed. As someone who has serious side effects and reactions it really gets to me.
The truth is that the EHR is intrusive in the individual patient encounter and does not, for the most part, improve care for that patient.
The truth is that EHR helps improve medical practice management by increasing practice efficiencies and cost savings.
A national survey of doctors who are ready for meaningful use offers important evidence:
79% of providers report that with an EHR, their practice functions more efficiently
82% report that sending prescriptions electronically (e-prescribing) saves time
68% of providers see their EHR as an asset with recruiting physicians
75% receive lab results faster
70% report enhances in data confidentiality
[Source: Jamoom, E., Patel, V., King, J., & Furukawa, M. (2012, August). National perceptions of EHR adoption: Barriers, impacts, and federal policies. National conference on health statistics.]
It is okay to not like EHR. But to deny it serves an important purpose in keeping the cost of making healthcare affordable for those who previously could not afford healthcare is self-delusion.
Quote:
Originally Posted by suzy_q2010
Will the data collected prove useful at some point in the future?
The truth is that EHR helps improve medical practice management by increasing practice efficiencies and cost savings.
A national survey of doctors who are ready for meaningful use offers important evidence:
79% of providers report that with an EHR, their practice functions more efficiently
82% report that sending prescriptions electronically (e-prescribing) saves time
68% of providers see their EHR as an asset with recruiting physicians
75% receive lab results faster
70% report enhances in data confidentiality
[Source: Jamoom, E., Patel, V., King, J., & Furukawa, M. (2012, August). National perceptions of EHR adoption: Barriers, impacts, and federal policies. National conference on health statistics.]
It is okay to not like EHR. But to deny it serves an important purpose in keeping the cost of making healthcare affordable for those who previously could not afford healthcare is self-delusion.
EHR isn't only about data collected. See above.
DH and I had dinner last night with friends, husband and wife, who are both pediatricians. We were already familiar with their EHR saga. They established a new practice a few years ago. The male half of the two had already developed and sold three practices. He got bored in retirement so they started the new one, at which time they researched and implemented an electronic record that was supposed to integrate everything from the health record to insurance billing to prescribing and transmission of the Rx to the pharmacy. They just scrapped that system and bought another one. He said his advice to a doc who had not bought an EHR would be to not do it.
These doctors are very computer savvy. They have used computers since the first PCs came out. They are not stupid. At the level of patient care, the records tend to be clunky, time-consuming, and totally frustrating to the people who have to use them. In a busy pediatric practice, an uncomplicated well child visit or minor illness visit could be completely documented in a half dozen written lines on a piece of paper. If the EHR duplicated that entry, all would be well and good. Getting the info on the EHR, however, involves dozens of screens, demands entry of unhelpful information to get from one screen to another, and takes more time than the actual patient care.
How is that efficient? How is that going to make health care more affordable? Only if the cost of the EHR is borne by the practice using it.
Computers are great for scheduling and billing. That is practice management. The software for the actual health record is by and large abysmal.
Edited to add: there is also the fact that if the computer system goes down, you have no access to records at all.
Dont forget the consumption taxes; 20% VAT on good & services, $10 a gallon for gasoline.
What relevance does that have on the price of healthcare ? medications don't have VAT and that $10 gallon of gas gets you 65+mpg.
My point was income tax not VAT (which by the way is added to the price of goods before you pay for them not after as in the US) and the price of gas is totally irrelevant IMO.
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