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ME-P in the Forefront of “Reasonable” Skepticism
By Staff Reporters
There is no doubt that paper medical records can cause harm. They are easily lost and damaged, they disappear during emergencies, and they are often incomplete.
With incorrect or missing information, doctors end up duplicating tests, making uninformed decisions and delaying care.
Another POV
Well true enough, but redundancy also reduces the instantaneous and widespread electronic dissemination of incorrect information. For example, we’ve all seen patients allergic to the drug ampicillin, being confused with the drugs penicillin, amoxicillin, dicloxacillin, ticarcillin and bicillin, etc.
Now, just suppose an eMR patient history was inputted incorrectly by a doctor, nurse, or some medical assistant or lightly trained technical aide? Instant error dissemination – times a zillion!
So, paper notes and medical charting redundancy does involve a bit of double-checking, which is a good thing!
THINK: Wrong sided surgery, never-events, etc.
The Skeptics
Patients – and all of us – deserve better, of course. And, we are naturally skeptical here at the ME-P. But, are electronic charts really the answer?
Alexander Friedman MD [Fellow in maternal-fetal medicine at the University of Pennsylvania], author of this new WSJ essay, sure doesn’t seem to think so. He joins these other experts, opining both for and against eMRs on this ME-P.
Channel: https://healthcarefinancials.wordpress.com/category/information-technology/
Assessment
Link: http://online.wsj.com/article/SB126599531264644979.html
Conclusion
And so, your thoughts and comments are appreciated. Tell us what you think about eMRs. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too! Then, be sure to subscribe to the ME-P. It is fast, free and secure.
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Filed under: Information Technology, Professional Liability | Tagged: Alexander Friedman MD, EHRs, EMRs, never-events, wrong sided surgery, WSJ |
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The Cleveland Clinic Fails to Recoup its $100 Million Investment
For those interested in health information technology, there is now an excellent, new, powerful website about this topic called the Huffington Post Investigative Fund.
In their most recent report, “Can Cleveland Clinic Be a Model for Digital Medicine?” they discuss how this hospital system failed to recoup their $100 million investment to date.
So, here is the take of Dr. Alberto Borges on the Cleveland Clinic story, beyond the fact that they failed to get a cost savings: http://www.hcplive.com/primary-care/blogs/The_HIT_Realist/1209/cleveland_clinic
Note: Alberto Borges, MD, is in private practice and is an assistant clinical professor of medicine at The George Washington University School of Medicine and Health Sciences in Washington, DC. He is also a noted ME-P thought-leader.
Hope Rachel Hetcio; RN, MHA
[Managing Editor]
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Paper Chart Documentation and Forensics
We have all been warned about altering a chart. This week, I heard a lecture by a board certified forensic specialist who deals with handwriting analysis. You would be a fool if you think that you can outsmart these people. Without going into detail, they have so many methods of determining when things are written that I don’t believe anyone could get away with that. DON’T DO IT.
If, after reviewing your chart, you find that it is incomplete, there is no reason that you can’t add a note that further explains your findings or your thinking. Make sure the note is in chronological order and is dated and signed on the day you write it. Never obliterate a note or “white it out.” You may draw a single line through a note that is incorrect, then date the time that you drew the line.
SOURCE: Dr. Michael Forman, DPM
Cleveland, OH
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So which would be more convincing as courtroom testimony; paper or digital?
D. Kellus Pruitt; DDS
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eMRs – A Poor Communication Vehicle
I agree with Dr. Alexander Friedman above; and others.
Just because eMRs improve information sharing and retrieval, it doesn’t necessarily follow that communication with patients and colleagues will also be better.
This month, the Center for Studying Health System Change, a nonpartisan health policy research organization in Washington, released a study on the effects of EMR on physician communication. The researchers conducted in-depth interviews with the doctors and staff from 26 small and medium-sized practices across the country that used the electronic system in their offices for at least two years.
http://www.hschange.org/CONTENT/1125/
Sorry, the eMR technology and security just isn’t there yet. It will be eventually; but not now despite HI-TECH and ARRA subsidies.
Dr. David Edward Marcinko; MBA
[Editor-in-Chief]
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On … Practice Fusion eMRs
I recently had a conversation with a representative from Practice Fusion in my capacity of developing a Health Information Exchange [HIE]. Health information exchanges are an important part of the whole network of EMR’s that we will all need to work with.
From what I understand, the ‘totally free’ part has MAJOR strings. There are features that you will need in order to qualify for the [ARRA-HITECH] stimulus checks that are add-ons and will cost extra. In addition, they told me that the software displays advertisements to your patients when they access the patient portal. The person whom I spoke with did not demonstrate a good understanding of “meaningful use”, or what is needed to qualify for the stimulus money. After the phone call, I felt that this was not a company that I wanted to be involved with.
Finally, I have strong reservations about integrating one company’s EMR with another company’s Practice Management system. If the communication is not working properly and the data ends up in the wrong place, you have major problems, and each company will point the finger at the other. Nobody will take responsibility for the interface. No matter whom you use, you are much better off with an integrated PM /EMR system.
Disclaimer: I provide consulting services on meeting the requirements for achieving the stimulus checks from: ICS – Sammy Software, Biomedix -Trak Med Software, IPS Physicians Systems and Quicknotes.
Source: Dr. Michael L. Brody, DPM
Commack, NY
PM News: #3858
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New York Regional Extension Centers Put the EHR Cart Before the Horse
In an apparent violation of the spirit of recent federal legislation, two taxpayer-supported New York organizations will sponsor product demonstrations from “preferred” electronic health record vendors, even though their products have not been approved according to federally mandated procedures.
Read essay by Glenn Laffel; MD, PhD
http://www.thehealthcareblog.com/the_health_care_blog/2010/05/new-york-regional-extension-centers-put-the-ehr-cart-before-the-horse.html#comments
Laura
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More on Practice Fusion eMRs
I just received an email from Sabas Rodriguez at Practice Fusion regarding my recent post. As a result of the e-mail, I called Sabas. He was kind enough to clarify and correct some of the information that was previously provided to me.
First, the ads are not shown on the patient portal; they are shown on the physician interface.
Second, the features that cost extra are electronic claims submission and electronic eligibility checking.
Finally, in relation to patients, their income model is to sell de-identified patient information to clients, including drug companies.
I would like to publicly thank Sabas for correcting the incorrect information that was originally provided to me by another representative from Practice Fusion.
Source: Dr. Michael Brody, DPM
Commack, NY
PMNews #3859
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More On eHR Liability
The increasing use of Electronic Health Records (EHRs), “cloud-based” applications, Application Service Providers (ASPs), and offsite electronic storage has led to an increase in laws and court rulings governing them—and these could affect your practice.
http://www.kevinmd.com/blog/2011/07/liability-considerations-electronic-health-records.html
Edward
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