I recently saw a newsletter done by User Centric that had a couple interesting pieces.
First, Dr. Wendy Yee writes, “Most HCPs will bluntly tell you that they did not go through medical training to become data entry clerks. They also are highly sensitive to time requirements because their days can be brutally compressed.” Sounds a lot like my post EHR Software Makes Doctors Secretaries.
Dr. Yee also provides an interesting list of multiple items that are simultaneously going through a doctor’s mind while using an EHR:
- There must be a way to make order entry faster…
- What was the procedure code for that variation of a genetic test?
- Let’s see, should I order Test ABC or Test DEF (or both)?
- I need to check for Jane Doe’s lab results from yesterday.
- Why isn’t that med listed under antivirals?
- What does that obscure lab reading mean?
- Has the patient’s problem list changed in the last day or so?
- Why do I have to enter patient notes *this* way when the EHR at the teaching hospital has me enter it the other way?
- Are there additional contraindications?
- When was the patient’s last MRI?
- I’m running behind, but I still need to enter this script.
Is it any wonder that it’s not a simple task to make an EHR that a doctor will consider usable? Not impossible, but certainly a challenge.
User Centric will be at HiMSS, Chicago! Booth #3382 They’ll be demonstrating how eye tracking can be utilized to uncover opportunities to improve user interfaces. No, I don’t have any financial connection with them, but eye tracking is really cool technology. Plus, I’m happy to support anyone that I think can make a difference when it comes to making EMR software more usable.
Press for time? By who exactly? Isn’t that just code for pressed to make as much money as possible in the shortest time available?
The reason that doc’s don’t go into primary care is purely financial. No one is forcing them to see patients faster. The new lost cost concierge models of care let you see each patient for 30 minutes to an hour and limit the practice t0 1000 patients and still double their income to $400,000 a year with a simple $50 a month retainer (1000 patients x 12 months X $50) and guess what they ALL have and use an EMR.
Why do kaiser and group health docs not only have but use a clunky EMR like Epic? Hmm could it be because it works but the saving goes back into the system that installed it.
Lets all be honest. The reaon that doc’s don’t have an EMR is because it doesn’t make them more money. Pure and simple. Greed. If an MRI makes an ortho doc more money but doesn’t change outcomes guess what!!! they buy an MRI. If an EMR costs a doc time but improves patient safety and outcomes. They won’t buy it..
Only when we have a close loop system like Medicare where half of the salaries of all doc’s in this country are effectively paid by them can we see the leverage we need to implement them at a systems level but individual doc’s won’t adopt them for the small bonus until the profit exceeds the cost.
Stop acting like this is hard to do or that they didn’t go to school to do data entry. Who exactly is doing their chart notes now? Everyone can type 3 times faster then they can write so what is hte problem. Grow up and admit that the reason some countries in Europe have EMRs in 95% of all doc offices and we don’t is because of greed.
Thanks for the commentary. I can agree with you that many times it is about greed that people don’t want to implement. I don’t think I ever argued against that. In fact, I think this article supports your assertion that greed is the main reason why it’s not happening. However, do we really think that this fact is going to change?
The real point is that until the EHR systems learn to feed that greed, adoption will remain low. I’m not arguing if this is right or wrong, but it’s just the reality we face when talking about EHR adoption.
I’d also have to disagree with you that everyone can type 3 times faster than they can write. I’ve seen many doctors try to type and it’s painstaking to even watch. So, many of them have legitimate points that an EHR will slow them down. Call it greed. Call it business. Either way, it’s a reality that many doctors don’t want to face.
Mike Cummins is the CIO at VHA, and he’s posted an interesting commentary about interoperability…as it pertains to EMRs and Business IT platforms within the hospital setting.
https://www.vha.com/portal/server.pt?open=512&objID=1293&PageID=533411&cached=true&mode=2&userID=2