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  Did not play well with others, usually using outdated computer languages, and did I say expensive….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

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:

• 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!