The Future Of EMRs: Too Many Clicks And Too Little Savings

Kevin MD might be the honorary ambassador of EMR frustration. He recently wrote about his EMR disappointment. He writes, “It takes me over 50 mouse clicks, all while scrolling through dozens of screens, to document a straightforward office visit for a sinus infection. Refilling a single prescription electronically, which I do over a hundred times a day, takes over 10 clicks.” You’ve heard this story all before, right? It’s what no tech conglomerate making these machines will ever publicize — EMRs are for the most part, epic exercises in mindless clicks. And to make it worse, reports from left leaning publications say that digital health records offer little savings.

But what about all the savings that government promised? The New York Times writes that EMR are NOT saving us money. Turns out, these claims were based mostly on a 2005 Rand Corp. analysis (they projected that electronic records would save $81 billion annually). Although Rand has since recanted that statement.

Kevin is one of our favorite voices in the healthcare revolution. He admits, “The transition to electronic medical records has had some successes, most notably, a reduction of medication errors.” But when we look at the cost of time and satisfaction that these machines breed, we wonder, is this two steps forward, one step back?

Kevin says, “Until [EMR] evolve so that direct patient contact isn’t compromised, the true potential of electronic medical records will remain unrealized.”

He lays out some noteworthy facts, too:

  • An American Journal of Emergency Medicine study found that 43% of emergency physicians’ time was spent entering data into a computer.
  • This same group spent only 28% of their time talking to patients.
  • Throughout a standard 10-hour shift, a doctor would click a mouse nearly 4,000 times.

Doctors in training have it much worse, though.

  • Johns Hopkins University School of Medicine found that medical interns spent only 12% of their time speaking with patients.
  • This averaged ~8 minutes a day per patient.
  • These same students spent 40% of their time completing electronic paperwork on a computer.

Kevin’s conclusion? “Hurried [EMR] interactions… have real world consequences, such as diminishing patient satisfaction and increasing the rate of medication prescriptions.”

At the end of the day, both of these issues are derived from current financial model governing healthcare. It’s a major reason why we believe in the alternative i.e. direct care-style subscription model. For $10-100/mo.,  insurance-free, patients get free visits, discounted labs & Rx, and 24/7 doctor access (via phone/text/email/social media).

First, while patient satisfaction is declining in the industry at large, direct care patient satisfaction is an absolute. Why can we say this? The free market principles that guide a direct care practice NECESSITATE it. When people are paying to see a direct care physician, they are saying, with their money, that they are deriving a benefit. In a nutshell, if direct care practices don’t deliver high-quality care, patients will take their money elsewhere, meaning that the practice in quesiton won’t stay afloat. Sure, it sounds cutthroat, but at the end of the day, it motivates and incentivizes doctors to better serve patients.

Second, a direct care practice, especially one that can self-dispense prescriptions at wholesale, will prescribe fewer pills. Direct care is not abut throwing pills at the problem. Instead, it’s about properly identifying what’s ailing a patient, and offering them the right treatment. Yes, this takes time. But that’s why direct care fights for a model where docs can spend an ACTUAL 45 minutes with a patient.

And speaking of EMRs that don’t involve too many clicks, have you seen EMR? It’s direct care’s first dedicate EMR and Practice Management software. We use it here at our offices to do almost everything: manage schedules, handle invoices, fill prescriptions, request labs, and more. In our case, the EMR we use has to help us out. We’re on our own here at Atlas MD. This is a land of zero government subsidies. If something’s holding us back, we’re fortunate. We can get just rid of of it.