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EHRs – AMA versus ADA

16 Responses

1. D. Kellus Pruitt DDS, on October 7, 2014 at 3:47 PM said:

   Differing opinions on EHRs

   “Ebola in the U.S. Raises Questions About Electronic Health Records – WASHINGTON, D.C.

   The failure to diagnose the first case of Ebola in the U.S. during an ER visit last week in Dallas is raising questions about electronic health records after doctors didn’t receive the information taken by a nurse. National Correspondent Kristine Frazao looks into whether more medical records going digital is putting patient’s safety at risk.”

   Siouxlandnews.com
   October 7, 2014

   http://www.siouxlandnews.com/story/26719875/ebola-in-the-us-raises-questions-about-electronic-health-records

   Dr. Deborah Peel of Patient Privacy Rights tells Siouxlandnews that the oversight is a clear indication that “electronic health record systems in this country are not even close to ready for prime time.”

   Dr. Peel adds: “Physicians are looking at computer screens and they are not talking to them. Here’s the deal, there’s no record system in the world that is ever going to replace the doctor talking to you.”

   On the other hand, the American Dental Association promises, “EHRs provide long-term savings and convenience.”

   ADA News
   December 6, 2013

   http://www.ada.org/en/publications/ada-news/2013-archive/december/ehrs-provide-long-term-savings-convenience

   D. Kellus Pruitt DDS

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2. D. Kellus Pruitt DDS, on October 10, 2014 at 7:44 PM said:

   EHRs and differences of opinion
   [The value of EHRs?]

   An ever-expanding difference of opinion between the AMA and ADA:

   “Doctors, hospitals rethinking electronic medical records mandated by 2009 law – A revolt is brewing among doctors and hospital administrators over electronic medical records systems mandated by one of President Obama’s early health care reforms. The American Medical Association called for a ‘design overhaul’ of the entire electronic health records system in September because, said AMA president-elect Steven Stack, electronic records ‘fail to support efficient and effective clinical work.’”

   Richard Pollock
   [Washington Examiner October 10, 2014]

   http://washingtonexaminer.com/doctors-hospitals-rethinking-electronic-medical-records-mandated-by-2009-law/article/2554622

   On the other hand, an anonymous author of an ADA News article continues to assure the nation that “EHRs provide long-term savings and convenience.”

   [No byline, ADA News, December 6, 2013]
   No supporting evidence is offered

   http://www.ada.org/en/publications/ada-news/2013-archive/december/ehrs-provide-long-term-savings-convenience

   And now … Minnesota humor?

   Want to know something funny?

   In 2007, gullible lawmakers in Minnesota became so giddy over EHRs that they went out on a limb: Their votes caused Minnesota to became the first (and only) state in the nation to outlaw paper dental records, even as physicians increasingly reject them. Minnesota’s suspiciously vendor-friendly law – which requires dentists to “Meaningfully Use” EHRs regardless of increased cost and danger – takes effect on January 1, 2015.

   Is that not a hoot?

   D. Kellus Pruitt DDS

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3. D. Kellus Pruitt DDS, on October 12, 2014 at 6:13 PM said:

   EHRs and limited disappointment

   Outside the dental industry, healthcare providers are increasingly disappointed with the expense and danger of electronic health records.

   “Hospital e-records systems like Presbyterian’s cited in failures across U.S. – Electronic record systems similar to the one that was briefly blamed when a Dallas hospital didn’t spot the nation’s first Ebola case have been repeatedly cited in delays in treatment, dosage mistakes and failures to detect fatal illnesses.” By Miles Moffeit and Reese Dunklin, staff writers, Dallas Morning News, October 10, 2014

   http://www.dallasnews.com/investigations/20141010-hospital-e-records-systems-like-presbyterian-s-cited-in-failures-across-u.s..ece

   Dr. Scott Silverstein of Drexel University, a physician with vast experience in building clinical record systems, tells Dallas Morning News: “Over the years, we’ve seen problems with overhype and overenthusiasm of these systems, leading to design and implementation failures, and a total lack of regulation. The public needs to know more about what these systems can do.” He warns that EHRs can lead to “catastrophic situations.”

   Moffeit and Dunklin write: “Researchers and experts in the health care IT field — known as informatics — say the Dallas Ebola case underscores concerns of pressing public interest: lax regulation of the systems and secrecy from hospitals and computer vendors.” They add: “Many health IT experts want greater transparency about failures, especially given that hospitals such as Presbyterian have benefited from massive infusions of federal dollars to move from paper records to digital systems.”

   On the other hand, according to information made available to membership by the American Dental Association, EHRs in dentistry are an unchallenged success: “EHRs provide long-term savings and convenience.” (No byline, ADA News, December 6, 2013).

   http://www.ada.org/en/publications/ada-news/2013-archive/december/ehrs-provide-long-term-savings-convenience

   D. Kellus Pruitt DDS

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4. Darrell Pruitt DDS, on October 15, 2014 at 10:06 PM said:

   AMA criticizes MU

   “AMA letter offers extensive criticism of meaningful-use program – The American Medical Association and several other large healthcare organizations are lobbing more complaints at HHS over its incentive program for electronic health records.”

   Darius Tahir
   [Modern Healthcare]
   October 15, 2014.

   http://www.modernhealthcare.com/article/20141015/NEWS/310159943/ama-letter-offers-extensive-criticism-of-meaningful-use-program

   On the other hand, the ADA which has always been much more enthusiastic about mysterious Meaningful Use requirements for dentists has become noticeably silent about the busywork.

   Darrell Pruitt DDS

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5. D. Kellus Pruitt DDS, on October 25, 2014 at 12:57 AM said:

   Let’s try transparency – ADA

   The American Dental Association claims that EHRs offer savings. Yet …

   “The tragedy of electronic medical records – It wasn’t supposed to work out this way. Digitizing medical records was supposed to transform health care—improving the quality of care and the service provided to patients while helping cut out unnecessary costs. Just like IT revolutionized all other industries. Perhaps they still will. But lately, electronic medical record systems are getting nothing but votes of no-confidence from physicians, hospitals, insurers and IT experts.”

   J.K. Wall
   October 23, 2014.

   http://www.ibj.com/blogs/12-the-dose/post/50131-the-tragedy-of-electronic-medical-records

   The ADA also says EHRs offer convenience. Yet …

   “Interestingly, physicians who reported that their practice made extensive use of information technology actually spent more time on administration. While physicians using entirely paper records spent 15.5 percent of their time on administrative matters, administration accounted for 17.2 percent of time for those in practices using entirely electronic medical records and 18.0 percent of time for those using a mix of electronic and paper records.”

   (See: “The Human and Professional Costs of Medical Care in the United States: ADMINISTRATIVE WORK CONSUMES ONE-SIXTH OF U.S. PHYSICIANS’ WORKING HOURS AND LOWERS THEIR CAREER SATISFACTION,”

   Steffie Woolhandler
   David U. Himmelstein
   [International Journal of Health Services]
   Volume 44, Number 4, Pages 635–642, 2014).

   Click to access Physician%20admin%20time_IJHS.pdf

   The nationally representative survey of 4,720 U.S. physicians also revealed that those who spent more time on administration were markedly less satisfied with their careers. “Those who were very satisfied spent, on average, 16.1 percent of their time on administration, versus 20.6 percent for those who were very dissatisfied.”
   

   How well do dentists and staff like their electronic dental records? Hard to tell. EHRs are a taboo topic in dentistry – possibly because of the number of misinformed professionals with NPI numbers who were sucked in by stakeholders’ lies.

   So, do you think dentists’ EHRs are that much better than physicians’? Or do you think the ADA Business Resources™ might be hiding the truth about the cost and convenience of EHRs to protect profits? (The ADA seems unwilling to respond to consumers’ questions about the discrepancy).

   D. Kellus Pruitt DDS

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6. D. Kellus Pruitt DDS, on October 27, 2014 at 4:17 PM said:

   EHR: Differences of opinion

   “California hospital faces collapse after $77M EMR investment – Though they don’t always get a lot of publicity, car crashes like this aren’t unheard of in the EMR world. In fact, according to one vendor white paper, 73% of all EMR implementations fail, because the systems were implemented too quickly, don’t offer enough clinical content in their design and cost way too much. Clearly, health systems need to change the way they evaluate and purchase EMRs if they want to be successful.”

   Anne Zieger for Healthcare Dive
   October 27, 2014.

   http://www.healthcaredive.com/news/california-hospital-faces-collapse-after-77m-emr-investment/325650/

   Nevertheless, the American Dental Association continues to assure the nation that: “EHRs provide long-term savings and convenience.”

   No byline – ADA News
   December 6, 2013

   http://www.ada.org/en/publications/ada-news/2013-archive/december/ehrs-provide-long-term-savings-convenience

   D. Kellus Pruitt DDS

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7. D. Kellus Pruitt DDS, on November 16, 2014 at 6:13 AM said:

   EHRs: Why don’t physicians get it?
   [EHRs: Unlike dentists, physicians can’t seem to get it right]

   “Address economic flaws in Obamacare” – An opinion by Stephen Soumerai and Ross Koppel for the Boston Globe, November 15, 2014.

   https://www.bostonglobe.com/opinion/2014/11/15/address-economic-flaws-obamacare/QGVWyyJJXfVLqRQmJOsx4I/story.html

   Soumerai and Koppel point out that some of Obamacare’s policies are unsupported by scientific evidence, are costly, and often backfire. Along with the ACA’s plans for pay-for-performance, non-payment for preventable infections, and charging the sick more for health insurance, the authors also criticize plans to penalize doctors for failing to meaningfully use their taxpayer-subsidized EHRs:

   “Medicare and Medicaid will penalize doctors and hospitals who fail to use electronic prescribing and health records. Even though the government is investing $34 billion in subsidies and incentives to help buy these systems, most doctors find them clunky, ill-suited to medical needs, and damaging to patient-doctor interactions. In addition, there is little evidence that electronic health records improve health or efficiency.”

   On the other hand, the American Dental Association embraces the ACA’s Meaningful Use requirements as well as pay for performance (Dental Quality Alliance).

   http://www.ada.org/en/science-research/dental-quality-alliance/

   Yet you don’t hear dentists complaining – even though very few qualify for ARRA incentives and subsequent claw-back efforts by CMS. In addition, a December 6, 2013 ADA News article written by an anonymous author assures ADA members that EHRs like The Dental Record – the only EHR system endorsed by the ADA – offer dentists “long-term savings and convenience.” (No evidence provided).

   http://www.ada.org/en/publications/ada-news/2013-archive/december/ehrs-provide-long-term-savings-convenience

   EHRs in dentistry are going so smooth that after January 1, 2015, maintaining dental records on paper will be against state law in Minnesota.

   Minnesota dentists aren’t complaining about mandated, CCHIT-certified EHRs. So why can’t physicians get the hang of it?

   D. Kellus Pruitt DDS

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8. D. Kellus Pruitt DDS, on December 26, 2014 at 4:47 PM said:

   Physicians: Learn from dentists

   Perhaps physicians could learn a thing or two about security from dentists

   “2014 Was Landmark Year for Health Data Breaches – When it comes to health data breaches, 2014 was a milestone year. Healthcare organizations accounted for about 42 percent of all major data breaches reported this year, according to the Identity Theft Resource Center.” By Greg Slabodkin for HealthData Management, December 26, 2014.

   http://www.healthdatamanagement.com/news/2014-Landmark-Year-for-Health-Data-Breaches-49505-1.html

   While physicians cannot seem to keep patients’ identities safe, data breaches are virtually unheard of in dentistry. In fact, the American Dental Association continues to stand solidly behind their anonymous claim: “EHRs provide long-term savings and convenience.” (No byline, ADA News, December 6, 2013).

   http://www.ada.org/en/publications/ada-news/2013-archive/december/ehrs-provide-long-term-savings-convenience

   D. Kellus Pruitt DDS

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9. Darrell K. Pruitt DDS, on January 20, 2015 at 8:03 PM said:

   A showdown is drawing nigh

   Today, a press release touting the benefits of electronic dental records appeared on DrBicuspid titled, “EHR implementation, adoption still face challenges: Part 1,” written by Editor in Chief, Tony Edwards.

   http://www.drbicuspid.com/index.aspx?sec=sup&sub=pmt&pag=dis&ItemID=317151

   Mark Hollis, CEO of MacPractice, tells Dr. Bicuspid: “Outside of our government’s intentions, there are obvious benefits to dentists for implementing EHRs in a practice. Reducing the use of paper and eliminating charts, providing 24/7 access to clinical documentation from everywhere, streamlining patient flow and workflow in the office, potentially enhancing the ability to see and exchange patient data with other providers securely, and the capability of delivering better and safer care to patients are all potential benefits.”

   If I didn’t think my bolus of questions would scare away Mr. Hollis, I would ask him to clarify each of his counter-intuitive selling points, all at once:

   1. How are “government intentions” obviously a benefit to dentists for implementing EHRs? Physicians increasingly hate Meaningful Use requirements, and increasingly resisting their intrusion.

   2. Considering that the epidemic level of data breaches from healthcare providers is expected to get even worse in 2015 – especially from hackers targeting medical identities – in what way is “reducing the use of paper and eliminating charts” a benefit to dentists or patients? Unlike EHRs, paper records in metal filing cabinets cannot be hacked from the other side of the world. Not only is paper increasingly safer than digital, but it is also increasingly cheaper.

   3. With the rise in mortal danger of medical identity theft, as well as bankruptcy-level liability for dentists even if they self-report a breach of unencrypted PHI, just how important is it really for dentists to have “24/7 access to clinical documentation from everywhere”? Can you name even one situation where a phone call, fax or the U.S. Mail is inadequate. Let’s not forget, IT IS ONLY DENTISTRY!

   Since none of his claims can tolerate evidence-based science or marketplace transparency, I would guess that MacPractice has been the recipient of millions of dollars in stimulus money (taxpayers’ dollars) to promote Meaningful Use of certified EHR by dentists – including through DrBicuspid press-releases.

   As for the CEO’s suspicious promotion of tedious, time-consuming, meaningless MU requirements for dentists – which also subjects dental practices to additional federal audits – just today, a stinging interview appeared in Medscape titled, “Key Opinion Leader Says Healthcare Reform Handcuffs Doctors,” by Neil Chesanow.

   http://www.medscape.com/viewarticle/837394

   Chesanow: “In the interview, Drs Hayworth and Caplan discussed the challenges of physician practices remaining independent today; the problem of electronic health records (EHRs) turning physicians into ‘data entry clerks’; the overreach of the Health Insurance Portability and Accountability Act (HIPAA) in protecting patient privacy to the extent that ob/gyns are afraid to post photos in the office of the babies they deliver; the lack of liability protection for physicians in the Affordable Care Act (ACA); pressure from the federal government to practice ‘cookbook medicine’; the negative impact of new technology on medical practice; and managing inflated patient expectations in a new era in which cost control is a priority.”

   Darrell K. Pruitt DDS

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10. D. Kellus Pruitt DDS, on June 26, 2015 at 3:39 PM said:

    Transparency in dentistry starts with Gary Kaye DDS

    Yesterday, Gary Kaye DDS, founder of the New York Center for Digital Dentistry, posted an article in Dental Economics titled, “Does digital dentistry make you a better dentist?”

    http://www.dentaleconomics.com/articles/print/volume-105/issue-6/science-tech/does-digital-dentistry-make-you-a-better-dentist.html

    Not unexpectedly, the technology consultant’s answer is an “unequivocal yes.”

    Having personally witnessed the inferior quality of numerous Cerec crowns that were milled on in-office machines while patients waited, I wanted to post a comment asking Dr. Kaye if his favorable opinion includes CADCAM technology in dentistry. That is when I discovered that Dental Economics no longer allows comments following press releases like Dr. Kaye’s. As a favor to digital stakeholders who prefer not to be held accountable for their fantastic sales claims, Dental Economics’ invitation to “Write your review” is a dead end as well. Dental Economics just doesn’t want to hear it.

    And as is common for evasive dental technology consultants, Dr. Gary Kaye DDS also rejects the transparency offered by Twitter and Facebook.

    That’s too bad. Dr. Kaye’s unavailability means unlike his customers, he doesn’t have to answer questions about the cost and safety of electronic dental records…. I hear Dentrix can be hacked from dentists’ parking lots. (See: “Hard-coded credentials placing dental offices at risk,” posted on CSO, May 19, 2015).

    http://www.csoonline.com/article/2923887/vulnerabilities/hard-coded-credentials-placing-dental-offices-at-risk.html

    Hey, Dr. Gary Kaye: Unlike you, I am easy to find if there is anything you would like to publicly say. But then again, who knows if you will ever even read what I wrote about you? Sweet.

    D. Kellus Pruitt DDS

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11. Hope Hetico RN MHA, on July 21, 2015 at 9:00 PM said:

    Physicians Voice Dissatisfaction with EHRs at AMA Town Hall

    At a town hall meeting last night in Atlanta hosted by the American Medical Association, physicians expressed widespread discontent with electronic health records and the federal government’s Meaningful Use program. As the nation’s largest physician organization, AMA held the meeting to give voice to provider dissatisfaction with EHRs and to encourage doctors to share their experiences with EHR technology. A parade of physicians told the group their horror stories with EHR implementation.

    “We have a technology that brings graduate degree-educated people to their knees. There’s something not right here,” said AMA’s President Steven J. Stack, M.D. Despite the fact that more than 80 percent of U.S. physicians use EHRs, Stack commented that too often these tools “blunt their efficiency, diminish their effectiveness, and get between them and their patients.”

    Source: Greg Slabodkin, Health Data Management [7/21/15]

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12. Darrell K. Pruitt DDS, on August 10, 2015 at 11:06 PM said:

    “Nearly half of all physicians dissatisfied with EHR systems”
    Helio, August 10, 2015.

    http://www.healio.com/internal-medicine/practice-management/news/online/%7B2254da60-83ab-49c5-ba1f-0dc922043714%7D/nearly-half-of-all-physicians-dissatisfied-with-ehr-systems

    “EHRs provide long-term savings, convenience”
    ADA News, December 06, 2013

    http://www.ada.org/en/publications/ada-news/2013-archive/december/ehrs-provide-long-term-savings-convenience

    Darrell K. Pruitt DDS

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13. Darrell K. Pruitt DDS, on September 11, 2015 at 12:36 AM said:

    The Scientific American vs ADA News

    Whom should you believe? Reuters Health reporter Kathryn Doyle who takes personal responsibility for what she writes, or an anonymous American Dental Association employee?

    “Electronic Health Records Software Often Written without Doctors’ Input – The reason why many doctors find EHRs difficult to use might be that the software wasn’t properly tested, research suggests.” By Kathryn Doyle for the Scientific American, September 9, 2015.

    http://www.scientificamerican.com/article/electronic-health-records-software-often-written-without-doctors-input/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+sciam%2Ftechnology+(Topic%3A+Technology)

    “EHRs provide long-term savings, convenience.”- (no byline), ADA News, December 6, 2013

    http://www.ada.org/en/publications/ada-news/2013-archive/december/ehrs-provide-long-term-savings-convenience

    Darrell K. Pruitt DDS

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14. Darrell K. Pruitt DDS, on December 14, 2016 at 5:38 PM said:

    Difference of opinion: AMA vs ADA

    “Data tell tale of EHRs as physician time sink”
    By Troy Parks -Staff writer
    American Medical Association
    December 14, 2016
    https://wire.ama-assn.org/practice-management/data-tell-tale-ehrs-physician-time-sink

    So, what does the American Dental Association have to say about EHRs?

    “EHRs provide long-term savings and convenience.”
    No byline – ADA News
    December 6, 2013
    http://www.ada.org/en/publications/ada-news/2013-archive/december/ehrs-provide-long-term-savings-convenience

    The difference is, the ADA has financial interests in The Dental Record – “The only EHR system endorsed by the ADA.”

    Darrell K. Pruitt DDS

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15. Darrell Pruitt DDS, on June 29, 2017 at 10:59 PM said:

    AMA v. ADA

    American Medical Association:

    “Copy, paste, repeat: Widespread EHR practice could undermine care”
    Robert Nagler Miller
    Contributing Writer for AMA Wire, June 29, 2017.

    https://wire.ama-assn.org/practice-management/copy-paste-repeat-widespread-ehr-practice-could-undermine-care

    American Dental Association:

    “EHRs provide long-term savings and convenience.”
    No byline, ADA News
    December 6, 2013.

    http://www.ada.org/en/publications/ada-news/2013-archive/december/ehrs-provide-long-term-savings-convenienceMA v. ADA

    Darrell Pruitt DDS

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16. Darrell Pruitt DDS, on September 14, 2017 at 9:09 PM said:

    So who is wrong?

    “Survey: Healthcare Execs See Poor ROI from EHRs but Optimistic about Analytics”
    by Heather Landi for Healthcare Informatics, September 14, 2017.

    https://www.healthcare-informatics.com/news-item/analytics/survey-healthcare-execs-see-poor-roi-ehrs-optimistic-about-analytics

    On the other hand,

    “EHRs provide long-term savings and convenience.”
    No byline, ADA News, December 6, 2013.

    http://www.ada.org/en/publications/ada-news/2013-archive/december/ehrs-provide-long-term-savings-convenience

    Statements made by Healthcare Informatics and the ADA News cannot both be correct. So who is wrong?

    Darrell Pruitt DDS

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