April 28, 2014
Oregon went “all in” on health reform, firmly embracing the Affordable Care Act. They launched a very successful Medicaid expansion — a $2 billion federal experiment to prove the state could save money by managing patients’ care better, and, of course, the state’s own online marketplace to sell Obamacare insurance.
But that last point has been a huge problem.
The Cover Oregon board decided on Friday to ditch its troubled website and join up with the federal HealthCare.gov exchange instead.
April 1, 2014
It’s another case of hate to say we told you so. Looks like for too many doctors, their worst EMR fears have come true, proving to be expensive, a drain on staff and technically inadequate. A total of 45% of respondents to a study said that in fact, patient care is worse since implementing EMR.
March 27, 2014
March 26, 2014
Doctors groups are worried that their members won’t get paid because of an unusual 90-day grace period for government-subsidized health plans. Now they’re urging physicians to check patients’ insurance status before every visit.
September 24, 2013
Zackary Berger is a faculty member of the Johns Hopkins University School of Medicine. He contributed a new post to the Kevin MD blog (yes, we’re fans of Kevin, too!) because his institution recently switched from a home-grown EMR to EPIC, which as you know has been reputed to be an EPIC failure. Supposedly we’re reaching the “nexus” of electronic records and communication, a future where scientists and physicians and patients can give meaningful information and get meaningful insight in return.
Fact is, we think this future might remain for the time being just that, the future. That’s why we’re starting small, focusing our EMR on patients and docs having a meaningful electronic interaction. In time, this might lead to more paths of communication, and more meaning to be derived from digital data. The metaphor we use is this: imagine someone in a time predating the wheel, planning a system of stone roads. For now, maybe we should get the wheel spinning, and then see where we can go with it.
This complex highway of data and boxes and buttons might be a little premature. When Berger read an article by a colleague of his who is researching the use of these new EMRs he noticed something. Patients are given “access codes” in order to tap into the extraordinary benefits of these EMR programs. But guess how many people are actually activating them?
Only 20%. Hmmm, is that even a good number? Berger is wondering the same thing. We’re thinking it’s more like crickets in response to the big sell that is EPIC EMR, perhaps indicative of the disengaging reality of today’s EMRs.
September 18, 2013
We almost titled this post, A Day In The Morning…, because in Dr. Fred N. Pelzman’s case, he has to click through 50 meaningless fields and CTRL + ALT + DEL things, before he’s even gotten his morning coffee. Then there were the 12 arbitrary nutrition prompts that were finally whittled down to one semi-helpful question. Of course, skipping this portion required additional clicks. And don’t forget the auto-scheduling of colonoscopies ten years down the road, regardless of the fact that some patients needed a screening one, two, or five years later instead. But Pelzman describes his daily EMR experience as useful, like mashing clay in a pot with a stick and plotting patient data in cuneiform and then translating it back to English with pen and paper. Ouch. Seriously, doctor, we feel for you. We prefer our mornings meaningful, and useful, not meaningfully useless.
READ ABOUT DR. PELZMAN’S EMR EXPERIENCE ON KEVIN MD
And we agree completely. Patient care has nothing to do with how many times we click on something, how many different boxes we hastily fill out. But the way most EMR are designed nowadays, you’d think otherwise.
July 15, 2013
A new post from Dark Daily says that a study shows too many electronic alerts cause nearly 30% of primary care physicians to overlook essential clinical laboratory test results. This according to researchers, including Hardeep Singh (pictured left), M.D., MPH, who led the Michael E. DeBakey Veterans Affairs Medical Center research team. Unfortunately, it looks like EHR systems are plagued by ‘alert overload.’ Which is what we’d expect, though, in an industry producing lackluster products.
In total, 5,001 VA physicians were invited to participate in the study, and of the 2,590 primary care physicians (PCPs) who did, some 29.8% overlooked test results from an EHR alert system on at least one occasion. Singh and his researchers’ survey findings suggested three factors that could lead to missed results in EHRs:
May 22, 2013
Here’s a quick rundown of factors contributing to EPIC’s EHR software failure. (Previous link no longer available.)
TENS OF THOUSANDS OF FEATURES
Microsoft Word has approximately 1,200 features/functions (this is rough estimate), most of which are ignored by common users. The problem with EHR software, though, is that the market is filled with hoodwinking, one-size-fits-all “solutions” all gimmicking for doctor’s dollars. MS Word has a core base of users (the entire professional, semi-professional and college-educated world) who are familiar with core procedures and who can adapt to new features with each version. EHR/EMR software DOES NOT HAVE THIS ADVANTAGE. Asking people to sift through tens of thousands of buttons and features to “figure out” how to do something is an exercise in futility. Yet it actually happens on the marketplace.
