Post by unlawflcombatnt on Mar 16, 2013 21:47:00 GMT -6
Wow!
I thought I was one of the few who felt this way.
Apparently MANY doctors hate electronic medical records.
Thus far, they've proven to be complete disaster.
They reduce productivity by at least 50%.
They force doctors to spend an overwhelming majority of their time trying to type notes, rather than diagnosing and treating patients.
Whereas I could see 20 patients in 8 hours on the worst paper medical record system ever invented, it is now impossible to see more than 10 with electronic medical records.
This reminds me of economist Paul Krugman's statement about:
'a solution in search of a problem to fix.'
That's exactly what Electronic Health Records are: the solution to a problem that never existed. Electronic Health records solve no problems whatsoever.
And their implementation may take down the entire health care system.
from PhysiciansMoneyDigest
EHR Dissatisfaction on the Rise
March 5th, 2013
by Laura Joszt
"Electronic health records (EHRs) may be more prevalent in the health industry, but user satisfaction has dropped, according to a new survey of clinicians.
The American College of Physicians (ACP) and AmericanEHR Partners surveyed more than 4,000 clinicians between March 2010 and December 2012. During that time user satisfaction fell 12%, while the number of users who said they were “very dissatisfied” increased 10%.
“Dissatisfaction is increasing regardless of practice type or EHR system,” Michael S. Barr, MD, MBA, FACP, who leads ACP's Medical Practice, Professionalism & Quality division, said in a statement.
The most dissatisfied group was surgical specialists, while primary care physicians were more satisfied than medical subspecialists.
In 2012, 39% of clinicians said they would not recommend their EHR to a colleague, which was up from 24% in 2010. Furthermore, 34% said they were “very dissatisfied” with the ability of their EHR to decrease workload, an increase from just 19% in 2010.
Another problem with EHRs is that users are finding it difficult to return to productivity after implementing the technology. Almost a third (32%) of users said they had not returned to normal productivity compared to 20% in 2010. According to health information experts, users should expect it to take at least 3 months to return to pre-EHR implementation productivity levels, and there are a number of factors that determine that length of time, including size of practice — the larger the practice, the longer it take.
Of the clinicians surveyed, 71% were in practices of 10 physicians or less and 82% intended to participate in the Meaningful Use incentive program.
“These findings highlight the need for the Meaningful Use program and EHR manufacturers to focus on improving EHR features and usability to help reduce inefficient work flows, improve error rates and patient care, and for practices to recognize the importance of ongoing training at all stages of EHR adoption,” Barr said."
Comment(s)
Your comments are valuable to us. Thank you....
leigh morse
March 8th, 2013 - 06:29:48 PM
I have been in practice 20 years in family medicine. I was a faculty at a residency taking care of many complicated pts , have been in rural practice for 10 years , serve on numerous hospital committees, medicaid committees and teach residents and medical students. I have used various EMR's over 10 years now. We just went on EPIC and it truly is causing me to leave practice prematurely. I am 50. The government EMR regulations which Epic complies with has led to hundreds of [hours of] overtime work which I have no more hours in the day.
All of my partners feel similarly even the younger ones. It is way to complicated in rural family medicine where we have limited resources extremely busy days. Ordering on medicare patients takes forever and the computer support is absent.
The anticipated outcome of this drive will take years to see but now it is horrible. Why we didn't come up with a government required personal EMR....
--------------------------
Ada del Rivero Yamuy
March 8th, 2013 - 09:44:21 PM
I am a female General Practitioner, I see an average of 25 patients a day. The EMR slow me and since I implemented it one year ago I have to work more hours a day and one day during the week end to catch up with the workload.
I do not see how the EMR benefits patient care.
My system slows down or stopped working randomly and many times interferes with the office flow.
If EMR is the answer to a health care system that does not work well for the patients and physicians, the EMR has to be faster easy to use and more reliable. I am using Allscripts My Way from Costco I am paying $543 dollars a months and it is pretty bad.
---------------------------
Doug McPherson
March 9th, 2013 - 03:05:56 AM
I will not use EMR in my small urgent care office. I do use EMR when working for a large hospital in Albuquerque on occasion in an urgent care setting and everyone hates it. You can see half or less of patients per shift. I could not afford to implement this system in my small rural practice. The other providers I work with in Albuquerque gripe continually, but just shrug their shoulders. They receive an hourly wage, thus they don't care if fewer patients are seen. Oh, you could see more patients if you spend less than 5 minutes with them, but that isn't practicing medicine. That is pushing cattle through the chute.
EMR is only good for billing and enabling the government to keep track of your medical record.
----------------------------
Dennis Pank
March 9th, 2013 - 09:48:05 AM
As the EHR is implemented I am finding I am becoming more of a data entry technician as are many of my colleagues. This provides less time for patient interaction and greater possibility of diagnostic error as I do not have time to LISTEN to my patients. Sad part is nursing services are suffering the same, less time for patient care and more time for data entry technicians.
---------------------
Bala Iyer
March 9th, 2013
Since EMR began, no health personnel actually sees the patient, they are busy on the computers copying and pasting the first notes entered by the ED physician which is most often pathetic at best. Nurses have no knowledge about even what their patient is in the hospital for, only that they need to chart in the computer at regular intervals. Patient care has gone to the worst condition, probably pre-civil war era. Bedside medicine has been successfully replaced by desktop-side medicine..
---------------------
Sylvia Emory
March 9th, 2013
I am a family physician who has been in practice for 21 years. While on paper records, my usual production was about 30 patients a day. With our first EHR, ICchart,my production slowed to 24-25 patients a day. We had to switch to a new electronic health record recently, because our old system would not have met meaningful use or been ICD-10 capable. I am on GE centricity and have nothing positive to say about the system. My production is now at 18-20 patients a day. I am working minimum 12 hour days, plus extra time on weekends.
I never thought of retiring early, I am 57, but cannot keep up this pace. Much of the frustration comes from what I see is a record designed to transfer clerical tasks to clinical staff. Also, the medical record is now a billing document, rather than a tool for efficient clinical communication. In reading notes, it is sometimes very difficult to find where the important clinical content exists, amongst all the extraneous data. With the upcoming expected shortage in primary care, having production cut by 1/4-1/3 due to electronic health records, is concerning...."
---------------------
"William J. Sullivan, DO, FACP
March 10th, 2013....
We implemeted EMR In September, 2012. It has truly been a nightmare. Facing financial uncertainty from being forced to provide healthcare insurance to our employees, increased overhead, staff who haven't seen a pay raise in over 3 years, increased taxes, decreased and delayed reimbursements, uncertainty from a procrastinating Congress, now a 2% Medicare cut from sequestration and next week a vote on raising the minimum wage - we couldn't afford the risk to miss out on the EHR incentive payment. Our EHR vendor which came highly recommended priced their product to the dime on the incentive payment. Then came all of the extra expenses - thousands more than the government has promised to help us.
We were sold the latest computer product on the market and updated software. Our system was improperly installed by the vendor. It took 3 months to work out the bugs because they were out of state and would not send a technician back to Kansas to correct their mistakes. I finally had to threaten a lawsuit which got their attention. We are still using an independent IT support company locally. They make an office call nearly once a week at a cost of hundreds of dollars a month. In Ocotber, 2012 our office took a direct lightning strike that burnt through our surge protectors and knocked us off line for a week. Last week we found on an internal audit that over $5000.00 in office visits were never submitted to insurance companies because of EHR issues and electronic billing errors with our contracted billing firm who are also struggling. Billing and patient data have been lost in its entirety on some patients and we have literally had to start over on charts.
I am a traditional internist in private practice still seeing both office and hospital patients. I am dying a slow death at age 49. My wife and I are both providers. We are both computer smart. We are working sometimes till 11:30 at night and then the weekends. We have no life anymore. Somedays we just have to walk away from it all and let things go undone. I am concerned about increased liability risk because of the decrease time spent with patients and the flow of data WHICH IS NOT MORE EFFICIENT.
This week I saw my first medication error - the first in 19 years of practice because a prescription was doubled over in the EHR system (not our fault). This would never have occurred with my well run and organized paper chart system.
We are following Meaningful Use to a tee because I believe in honesty and integrity. Our patients could care less. They refuse their summaries and comment more about the increasing wait times, inefficiencies, and inconveniences they didn't have before September, 2012. We have hired and let go 3 office assistants (including a board certified assistant) because they cannot learn and keep up with our computer system.
Each time we hire a new employee the teaching process starts all over. In 19 years of practice I have never had to terminate an employee.
My business partner, who purchased the same equipment, turned her unit off last week and states that she will just take the risk of decreased payments and likely just retire if it comes to that.
Another physician who purchased the same equipment and software package in our community is closing his office one extra day per week and hired a mid-level to make up the difference so he can just do something else.
20% of the primary care physicians in our community have pledged to retire within 24 months - none of whom will buy an EHR - all are near or older than age 60.
As for my wife and I - we are actively pursuing other business interests to diversify our income to retire early because we frankly will not do this forever. We see no improvement but only more regulations, corruption, and bureaucracy that will only degrade the U.S. healthcare system and further embolden those few who will benefit greatly - the corporate CEO's and policy makers running for re-election.
We went into medicine for the art of healing. We are now hostages in the business of medicine. What we see clearly coming is a healthcare crisis like no one has ever known. This will include a critical shortage of credentialed healthcare providers, decreased quality of healthcare, and misdiagnosis and management because providers will be physically and mentally fatigued and increasingly burdened to pay for it all. If we cannot do the job right - then we are not going to do it at all. It may come to the reality soon that we too will have to turn our system off and resort to being a cash pay entity to survive and have a quality of life. Sorry for the harsh comments - it is what it is...."
---------------------
Bala C
March 10th, 2013......
Health care has been completely taken out of the hands of those who actually provide it and distributed between IT, lawyers and the govt.
Unless physicians get their act together and get their ability to unionize again and fight back, this profession is headed for disaster and with more and more physicians planning for early retirement, the care of patients will also suffer as there will be poor delivery of care..."
I thought I was one of the few who felt this way.
Apparently MANY doctors hate electronic medical records.
Thus far, they've proven to be complete disaster.
They reduce productivity by at least 50%.
They force doctors to spend an overwhelming majority of their time trying to type notes, rather than diagnosing and treating patients.
Whereas I could see 20 patients in 8 hours on the worst paper medical record system ever invented, it is now impossible to see more than 10 with electronic medical records.
This reminds me of economist Paul Krugman's statement about:
'a solution in search of a problem to fix.'
That's exactly what Electronic Health Records are: the solution to a problem that never existed. Electronic Health records solve no problems whatsoever.
And their implementation may take down the entire health care system.
from PhysiciansMoneyDigest
EHR Dissatisfaction on the Rise
March 5th, 2013
by Laura Joszt
"Electronic health records (EHRs) may be more prevalent in the health industry, but user satisfaction has dropped, according to a new survey of clinicians.
The American College of Physicians (ACP) and AmericanEHR Partners surveyed more than 4,000 clinicians between March 2010 and December 2012. During that time user satisfaction fell 12%, while the number of users who said they were “very dissatisfied” increased 10%.
“Dissatisfaction is increasing regardless of practice type or EHR system,” Michael S. Barr, MD, MBA, FACP, who leads ACP's Medical Practice, Professionalism & Quality division, said in a statement.
The most dissatisfied group was surgical specialists, while primary care physicians were more satisfied than medical subspecialists.
In 2012, 39% of clinicians said they would not recommend their EHR to a colleague, which was up from 24% in 2010. Furthermore, 34% said they were “very dissatisfied” with the ability of their EHR to decrease workload, an increase from just 19% in 2010.
Another problem with EHRs is that users are finding it difficult to return to productivity after implementing the technology. Almost a third (32%) of users said they had not returned to normal productivity compared to 20% in 2010. According to health information experts, users should expect it to take at least 3 months to return to pre-EHR implementation productivity levels, and there are a number of factors that determine that length of time, including size of practice — the larger the practice, the longer it take.
Of the clinicians surveyed, 71% were in practices of 10 physicians or less and 82% intended to participate in the Meaningful Use incentive program.
“These findings highlight the need for the Meaningful Use program and EHR manufacturers to focus on improving EHR features and usability to help reduce inefficient work flows, improve error rates and patient care, and for practices to recognize the importance of ongoing training at all stages of EHR adoption,” Barr said."
Comment(s)
Your comments are valuable to us. Thank you....
leigh morse
March 8th, 2013 - 06:29:48 PM
I have been in practice 20 years in family medicine. I was a faculty at a residency taking care of many complicated pts , have been in rural practice for 10 years , serve on numerous hospital committees, medicaid committees and teach residents and medical students. I have used various EMR's over 10 years now. We just went on EPIC and it truly is causing me to leave practice prematurely. I am 50. The government EMR regulations which Epic complies with has led to hundreds of [hours of] overtime work which I have no more hours in the day.
All of my partners feel similarly even the younger ones. It is way to complicated in rural family medicine where we have limited resources extremely busy days. Ordering on medicare patients takes forever and the computer support is absent.
The anticipated outcome of this drive will take years to see but now it is horrible. Why we didn't come up with a government required personal EMR....
--------------------------
Ada del Rivero Yamuy
March 8th, 2013 - 09:44:21 PM
I am a female General Practitioner, I see an average of 25 patients a day. The EMR slow me and since I implemented it one year ago I have to work more hours a day and one day during the week end to catch up with the workload.
I do not see how the EMR benefits patient care.
My system slows down or stopped working randomly and many times interferes with the office flow.
If EMR is the answer to a health care system that does not work well for the patients and physicians, the EMR has to be faster easy to use and more reliable. I am using Allscripts My Way from Costco I am paying $543 dollars a months and it is pretty bad.
---------------------------
Doug McPherson
March 9th, 2013 - 03:05:56 AM
I will not use EMR in my small urgent care office. I do use EMR when working for a large hospital in Albuquerque on occasion in an urgent care setting and everyone hates it. You can see half or less of patients per shift. I could not afford to implement this system in my small rural practice. The other providers I work with in Albuquerque gripe continually, but just shrug their shoulders. They receive an hourly wage, thus they don't care if fewer patients are seen. Oh, you could see more patients if you spend less than 5 minutes with them, but that isn't practicing medicine. That is pushing cattle through the chute.
EMR is only good for billing and enabling the government to keep track of your medical record.
----------------------------
Dennis Pank
March 9th, 2013 - 09:48:05 AM
As the EHR is implemented I am finding I am becoming more of a data entry technician as are many of my colleagues. This provides less time for patient interaction and greater possibility of diagnostic error as I do not have time to LISTEN to my patients. Sad part is nursing services are suffering the same, less time for patient care and more time for data entry technicians.
---------------------
Bala Iyer
March 9th, 2013
Since EMR began, no health personnel actually sees the patient, they are busy on the computers copying and pasting the first notes entered by the ED physician which is most often pathetic at best. Nurses have no knowledge about even what their patient is in the hospital for, only that they need to chart in the computer at regular intervals. Patient care has gone to the worst condition, probably pre-civil war era. Bedside medicine has been successfully replaced by desktop-side medicine..
---------------------
Sylvia Emory
March 9th, 2013
I am a family physician who has been in practice for 21 years. While on paper records, my usual production was about 30 patients a day. With our first EHR, ICchart,my production slowed to 24-25 patients a day. We had to switch to a new electronic health record recently, because our old system would not have met meaningful use or been ICD-10 capable. I am on GE centricity and have nothing positive to say about the system. My production is now at 18-20 patients a day. I am working minimum 12 hour days, plus extra time on weekends.
I never thought of retiring early, I am 57, but cannot keep up this pace. Much of the frustration comes from what I see is a record designed to transfer clerical tasks to clinical staff. Also, the medical record is now a billing document, rather than a tool for efficient clinical communication. In reading notes, it is sometimes very difficult to find where the important clinical content exists, amongst all the extraneous data. With the upcoming expected shortage in primary care, having production cut by 1/4-1/3 due to electronic health records, is concerning...."
---------------------
"William J. Sullivan, DO, FACP
March 10th, 2013....
We implemeted EMR In September, 2012. It has truly been a nightmare. Facing financial uncertainty from being forced to provide healthcare insurance to our employees, increased overhead, staff who haven't seen a pay raise in over 3 years, increased taxes, decreased and delayed reimbursements, uncertainty from a procrastinating Congress, now a 2% Medicare cut from sequestration and next week a vote on raising the minimum wage - we couldn't afford the risk to miss out on the EHR incentive payment. Our EHR vendor which came highly recommended priced their product to the dime on the incentive payment. Then came all of the extra expenses - thousands more than the government has promised to help us.
We were sold the latest computer product on the market and updated software. Our system was improperly installed by the vendor. It took 3 months to work out the bugs because they were out of state and would not send a technician back to Kansas to correct their mistakes. I finally had to threaten a lawsuit which got their attention. We are still using an independent IT support company locally. They make an office call nearly once a week at a cost of hundreds of dollars a month. In Ocotber, 2012 our office took a direct lightning strike that burnt through our surge protectors and knocked us off line for a week. Last week we found on an internal audit that over $5000.00 in office visits were never submitted to insurance companies because of EHR issues and electronic billing errors with our contracted billing firm who are also struggling. Billing and patient data have been lost in its entirety on some patients and we have literally had to start over on charts.
I am a traditional internist in private practice still seeing both office and hospital patients. I am dying a slow death at age 49. My wife and I are both providers. We are both computer smart. We are working sometimes till 11:30 at night and then the weekends. We have no life anymore. Somedays we just have to walk away from it all and let things go undone. I am concerned about increased liability risk because of the decrease time spent with patients and the flow of data WHICH IS NOT MORE EFFICIENT.
This week I saw my first medication error - the first in 19 years of practice because a prescription was doubled over in the EHR system (not our fault). This would never have occurred with my well run and organized paper chart system.
We are following Meaningful Use to a tee because I believe in honesty and integrity. Our patients could care less. They refuse their summaries and comment more about the increasing wait times, inefficiencies, and inconveniences they didn't have before September, 2012. We have hired and let go 3 office assistants (including a board certified assistant) because they cannot learn and keep up with our computer system.
Each time we hire a new employee the teaching process starts all over. In 19 years of practice I have never had to terminate an employee.
My business partner, who purchased the same equipment, turned her unit off last week and states that she will just take the risk of decreased payments and likely just retire if it comes to that.
Another physician who purchased the same equipment and software package in our community is closing his office one extra day per week and hired a mid-level to make up the difference so he can just do something else.
20% of the primary care physicians in our community have pledged to retire within 24 months - none of whom will buy an EHR - all are near or older than age 60.
As for my wife and I - we are actively pursuing other business interests to diversify our income to retire early because we frankly will not do this forever. We see no improvement but only more regulations, corruption, and bureaucracy that will only degrade the U.S. healthcare system and further embolden those few who will benefit greatly - the corporate CEO's and policy makers running for re-election.
We went into medicine for the art of healing. We are now hostages in the business of medicine. What we see clearly coming is a healthcare crisis like no one has ever known. This will include a critical shortage of credentialed healthcare providers, decreased quality of healthcare, and misdiagnosis and management because providers will be physically and mentally fatigued and increasingly burdened to pay for it all. If we cannot do the job right - then we are not going to do it at all. It may come to the reality soon that we too will have to turn our system off and resort to being a cash pay entity to survive and have a quality of life. Sorry for the harsh comments - it is what it is...."
---------------------
Bala C
March 10th, 2013......
Health care has been completely taken out of the hands of those who actually provide it and distributed between IT, lawyers and the govt.
Unless physicians get their act together and get their ability to unionize again and fight back, this profession is headed for disaster and with more and more physicians planning for early retirement, the care of patients will also suffer as there will be poor delivery of care..."