EMR-Electronic Medical Record
My medical practice has been interviewing vendors for a new practice management system and electronic medical record.
For you non-medical types the practice management system helps automatize appointments, billing, insurance filing, and accounts receivable/payable. The electronic medical record or EMR actually takes the place of your paper medical chart in the Doctors office.
For you medical types, they are just another pain in the ass-(just kidding-maybe:)
EMR History
I was first exposed to an EMR in a hospital environment during my residency training. The attending/private docs yelled and screamed so much about it, only the residents had to use it.
I am sure since that time 25 years ago, a lot has changed about EMR’s , but Doc’s resistant to change-probably not so much…
I have been computer interested since the first IBM PC was released. I was probably the one of the first in my town to have a net book and PDA years and years ago….And used a “bulletin-board” before Al Gore invented the internet….
However, I have not pursued an EMR for my practice until now.
EMR-Not Ready for Prime Time!
They were just not ready for prime time, in my small mind.
They were extremely expensive. Did not play well with others, usually using outdated computer languages, and did I say expensive….
I practice in a rural area, and though I love it here, our financial remuneration is much less than my friends in the big city…So paper it was…
So what changed?
- Cloud computing-having to buy software, hardware, and expensive upgrades sucks.
- Penalties and rewards-the new HiTech Act as part of the Healthcare/stimulus/government give-away orgy! Physicians will now be penalized on reimbursement if they do not begin using EMR’s. And rewarded with stipends and increased reimbursement if the transformation to digital is successful-in your practice.
- Retirement-NOT-Deciding that I would have to practice at least 5-10 more years before I could ride off into the sunset…(ie pay off my office building:)
EMR Criteria
What were our criteria for our interview process?
- Must be cloud based
- Large company-financially sound-with a track record
- Use our existing hardware where possible
- No expensive up-grades or planned obsolescence
- Must be able to communicate with our local hospital, our lab and other vendors.
- Quality customer service/satisfied end-users willing to talk!
Not my first rodeo
And we had done this interview/review process before a few years ago, and decided to put it off then.
And the results are (drumroll please!!!!)
athenahealth (yes no caps is correct)-Stock symbol ATHN is traded on Nasdaq. I have been an admirer of their CEO Jonathan Bush during his interviews through the years on Squawkbox, the early morning show on the CNBC business channel.
He usually hit the challenges facing the health care business on the nose, and his company (and stock) has done well!
athenahealth Concerns
What are my concerns?
- We have to add new PCs
- Upgrade our net speed
- Upgrade our wireless
- Who knows what the federal government will do with the HiTech Act program. If it disappears, can you say “Doc crying!”
Jonathan, are you listening?
A few suggestions to Jonathan- if he is listening:
First EMR User? (by mke licht c.c.)
- Find an inexpensive tablet that will work with your system-the ones I have looked at are $2500 bucks apiece-not cool when you can get an iPad for 5oo bucks! Read this link about iPads and EMR’s Aren’t we trying to save money here!
- Improve the readability of the pdf on tech requirements and hardware needs/suggestions-my office manager who makes me look lazy, but is in her 70′s said “Do What?” Put it in layman’s terms with examples-have another more detailed spec sheet for the techies…
- Decrease the High Pressure Sales: I felt as if I was dealing with a used car salesman at times. Even using the “Let me check with my manager” line, as well as “We won’t be making anything at this rate, but we will do it to get into your area!” Yeah right…
But all in all I am satisfied so far with our choice. But the proof will be in the installation and follow-up.
I will keep you posted.
Reader Questions:
Have you been to a Doc who had an EMR, and used a tablet or PC in the exam room? Did it bother you?
Have you had your prescriptions sent to the pharmacy in digital fashion? Cool huh!
Did you get a printout of your diagnosis with helpful information/suggestions? (I know you ignored the exercise/lose weight suggestion!)
Love to hear your experiences-and you nurses-chime in with your EMR horror stories-I know you have them!
Tags: a new practice management system, athenahealth, electronic medical records, EMR, implementing electronic medical records
I have been to a doctor that had everything on PC and it does not bother me at all.
It will be the only way in the next few years! I guess we all have to get used to it!
Thanks for sharing
[...] This post was mentioned on Twitter by Dr. Dean Burke, Dr. Dean Burke. Dr. Dean Burke said: New Blog Post: EMR-Why You Should Care! http://bit.ly/dXGUZI [...]
My wife’s office (Los Angeles OB/GYN) is looking for software too. They have a partial system where they can make appointments and fill prescriptions electronically. They are having difficulty finding reasonably priced software that will fit with the existing system. Another difficulty is to supporting the medical specialty in the software.
Thank you for your post. I agree that a good electronic medical record was not ready for prime time since their inception over 20 years ago, and probably will not be the “magic” to reform healthcare.
However they have come a long way since then. There are some that are now “cloud based”, integrated with an HIE, fast and easy to learn and use, and fits into any workflow. And as you indicated, a good system must be easily integrated into other disparate systems and partners.
We still have problems in our Healthcare system, and an EMR will only get us so far. I believe that this is just one part and the first step to our dilemma in this country. The transition to digital records is sometimes a painful one for practices as staffs have to take time to scan and upload the clinical data, and thought has to go into the reengineering process as a whole. You have process and training to consider, and the time and expense of maintenance and support in most cases as you’ve outlined. Hence, the stimulus monies to assist in offsetting some of these costs to the physician.
One of the reasons healthcare costs are so high in this country is because we have a lot of redundancies built into our healthcare practices. Patients see one physician for a malady, are sent out for tests, and then get referred out or see a specialist and are requested to take all the same tests again. Doctors have their own charts on each patient. If a patient is seen by 4 or 5 physicians, they all have a different slice of that pie. To make the best decisions, the physician should have a view at the whole, not just his slice. What medications is the patient on? Which tests has the patient already had done? What problems have other physicians already identified on this patient? If the physician doesn’t know, he’ll just have to spend the time and cost to duplicate the efforts to attain the information.
The costs are inflated with duplicative efforts and testing. To avoid some of these duplication situations, we need to migrate to using on a regular basis the collective information we have. An EMR will only digitalize. The key is to then share and move the clinical data amongst these physicians in a collaborative effort. Utilizing an EMR with an integrated HIE will assist in this practice. If the EMR and HIE are free to the physicians, that is even better. There are free integrated HIE/EMR/PHR offerings available that are funded by advertising. Use the stimulus for your office reengineering and scanning efforts, and allow the technology available to assist in the digitalization and collaborative efforts.
For more information on this free technology, (did I say FREE?) see mitochon systems
A free and easy cloud based and integrated solution may not solve all the healthcare problems in this country, but it sure will help!
Good luck with your EMR implementation efforts!
No doubt reasonably priced is difficult to come by. And the stimulus Hi Tech act will not be bringing prices down. The vendors see that as a reason to increase prices. FREE MONEY!!!
Our MD’s use laptops and its very cool. Also have the link with the pharmacy. On the other side, a close doctor relative has his share of challenges with the emr system at work. I don’t envy you having to choose and set up the system!
Like hitting your head with a hammer over and over. It will feel good when I finish…
[...] change bother you. My office is changing our Practice Management System, and EMR-and we are all stressed out about [...]
I had a doctors appointment in a new office the other day. They asked me to come in 15 minutes early to fill out paper work. I came in and as soon as i started filling it out i realized that I couldn’t remember anything about my previous medical history, such as the surgeries underwent and medications i was prescribed in the past to who my doctors were. I can see how beneficial it is to the consumer to own a PHR. Companies not only like Medefile Records would not only benefit people but also save time if ever in a emergency. Doctors would make far less mistakes anytime, or anywhere.
[...] I just left my office on beautiful South Georgia Saturday morning having let Keith, the computer guy, in to unbox 8 PC’s as part of our move into the 21st century- with a new practice management system and an EMR! [...]
EMR systems will be required to export CCR/CCD documents for patient medical records to enable history portability.
YAY for EMR!
Hope you find great joy in it. You seem pretty tech-centric, so just take a deep breath and think of all it CAN do and DOES do an not the challenges that it prevents.
EMR is a glass that is totally half-full!
Based on HIMSS reports for the last few years, there has been rapid pace in the adoption of EMR technology. Barriers to adopting EMR have majorly been overcome.