I was led to believe that switching to an Electronic Medical Record would save time.

[Tobra]

Turns out I was misinformed. The pharmacists and the pharmacy board say every prescription needs either verbal confirmation, or a prescription with a wet signature faxed to them. For Class II, narcotics, there are these "security" prescriptions that you are to use, so for that stuff they need an actual prescription in their hand.

If I am going to go to call the pharmacy, or print a prescription and fax it, it does not make any sense to also send it electronically via modem also. Doing everything twice does not seem like an efficient use of resources. I don't see me doing it.

What a PITA it is becoming to take care of people.

[svandamme]

In Holland, i used to go to the doctor, he'de prescribe something, and ask me "which pharmacy"
I'de answer and as fast as i could get there, the pharmacy had the prescription waiting for me.


That's probably the only thing in Holland that i found to be better then elsewhere.
The rest was pants.

[Gogar]

But think of all those new jobs you're creating!

[gshase]

I am still waiting for my Free TV, OBAMA

[Brando]

Originally Posted by Tobra

Turns out I was misinformed. The pharmacists and the pharmacy board say every prescription needs either verbal confirmation, or a prescription with a wet signature faxed to them. For Class II, narcotics, there are these "security" prescriptions that you are to use, so for that stuff they need an actual prescription in their hand.

If I am going to go to call the pharmacy, or print a prescription and fax it, it does not make any sense to also send it electronically via modem also. Doing everything twice does not seem like an efficient use of resources. I don't see me doing it.

What a PITA it is becoming to take care of people.

That's what your staff is for - or rather, you're supposed to hire more "medical records" staff members.

Actually going to a digital system is very beneficial once fully adopted. It's the other regulations that make it cumbersome.

[charlesbahn]

I was led to believe that switching to an Electronic Medical Record would save time.


Ha Ha Ha Ha!

[pavulon]

A lot of EMRs suck--especially for having been around for 30 years.

[aap1966]

EMR systems are like communism, terrific in theory, an absolute friggen disaster in reality.
One quiet night shift, I'll start a thread about the time my hospital tried to implement one. Still provides good dinner party laughs almost 10 years later.

[Moses]

I'll post more on this later... What we have now is about 100 EMR companies scrambling for market share and Federal dollars. The current approach is based on proprietary data. Inter-platform data exchange is difficult by design. Banking made the same mistakes until International Banking groups REQUIRED all banking software to be open source. Now you can have a secure, private, accurate financial exchange between a bank in Bolivia and one in Hong Kong.
Medicine is not even close. EMRs create more work, less communication and have been documented to contribute to MORE dangerous medical errors. (Google CERNER)

[beepbeep]

dunno about US, but in Sweden a doctor will proscribe the medicine and you can pick it up after 5 minutes in any farmacy, even the private ones.

It works.


But they did have a 5-days glitch when no E-recipe worked due to EMC SAN they used for storage went tits up. No electronic access to DMV or prescription for a week for whole country! But that's another story

[wdfifteen]

What I like about it is everything can be accessed by me in one place. All the doctors I see, all the meds that have been prescribed plus the ones that were issued. Just log in and it's there. We'll see how well this is working three years out.

[Chocaholic]

Originally Posted by Moses

I'll post more on this later... What we have now is about 100 EMR companies scrambling for market share and Federal dollars. The current approach is based on proprietary data. Inter-platform data exchange is difficult by design. Banking made the same mistakes until International Banking groups REQUIRED all banking software to be open source. Now you can have a secure, private, accurate financial exchange between a bank in Bolivia and one in Hong Kong.
Medicine is not even close. EMRs create more work, less communication and have been documented to contribute to MORE dangerous medical errors. (Google CERNER)

That's because there's really no truly "vendor agnostic" solutions that are enterprise viable. When companies like GE, Philips, Siemens, McKesson, Cerner, etc., have partnerships and related technologies, there's much for them to gain by "tying" things together and locking customers in. Once an EMR infrastructure is established, it's beyond painful to change (HIS, RIS, PACS, Path, SR, etc.). So instead, the entrenchment becomes deeper. Then there was the federal mandate to to digitize medical information. Will stop there to keep this out of PARF.

[Moses]

Originally Posted by Chocaholic

That's because there's really no truly "vendor agnostic" solutions that are enterprise viable. When companies like GE, Philips, Siemens, McKesson, Cerner, etc., have partnerships and related technologies, there's much for them to gain by "tying" things together and locking customers in. Once an EMR infrastructure is established, it's beyond painful to change (HIS, RIS, PACS, Path, SR, etc.). So instead, the entrenchment becomes deeper. Then there was the federal mandate to to digitize medical information. Will stop there to keep this out of PARF.

The missing step is a Federal mandate that all info be open source. The CLOUD. Just like banking. In that way, ALL relevant data is recoverable and accessible. Radiology, hospital records, pharmacy, doctors offices, insurance companies. EVERYTHING. The concept that the EMR providers have proprietary access to your health care records is insane and renders every system functionally useless.

Banking figured it out. The EXACT same model will work for healthcare once the government quits funding these "Solyndra" clones.

[Noah930]

That's my biggest beef with the EMR mandate. None of the systems talk to each other. So how is mandating this considered progress?

Of course if there is some cloud- or internet-type accessibility to health records, then there's a whole new problem with security of PHI (protected health information). Though maybe I can watch one safety/sensitivity video that'll satisfy the requirements of all the different clinics/hospitals I go to, instead of wasting my time watching them at each individual place.

EMR: often touted as time- and money-saving by those who don't have to use it.

[Moses]

Originally Posted by Noah930

Of course if there is some cloud- or internet-type accessibility to health records, then there's a whole new problem with security of PHI (protected health information)

The worlds financial markets are encrypted and secure. A far bigger challenge than protecting a the records of a presidential colonoscopy.

[Joeaksa]

Just wait until the 1st of January... thats when Obuma care will really start to screw everyone...

[Noah930]

Originally Posted by Moses

The worlds financial markets are encrypted and secure. A far bigger challenge than protecting a the records of a presidential colonoscopy.

Yes, but part of the difference is that in banking, there are a finite number of users who access the system. They're all through banks. Done at the bank. There are only so many banks out there.

But in medicine, there are an exponentially larger number of medical providers: medical offices, therapists, pharmacies, hospitals, radiological centers, pathologists, labs, etc. Plus, people (doctors) will want to access the system remotely, as in from home. There will be far more people accessing the medical record system compared to a banking system. Keeping medical records private is going to be a far bigger challenge. Not insurmountable, but a bigger headache nonetheless. Look how hard it is to keep a celebrity's medical records private when they go to a medical center or hospital. Virtually any employee in the hospital can look up the person's labs or path reports on the hospital computer system. Making people sign in and sign out isn't a deterrent. What happens when any nurse, doctor, therapist, or lab technician anywhere in the country can log in and access anyone else's medical records?

In banking, stuff is done anonymously, by bank account numbers. There's no correlation between an individual and their bank account numbers. In medicine, stuff is done via name/DOB/SSN. And for the medical system to work effectively, that info has to be accessible even if a patient arrives in an ER, unconscious. Again, it's going to be a lot more complicated than banking. There's going to have to be a whole new infrastructure set up. And if people want to game the system by providing false identifying information at each ER visit, we're still stuck in the same boat.

[Por_sha911]

Wait until the insurance companies, employers and even landlords start accessing your medical records to determine if you are a risk.
Big Brother is Watching.

[Moses]

Originally Posted by Por_sha911

Wait until the insurance companies, employers and even landlords start accessing your medical records to determine if you are a risk.
Big Brother is Watching.

For right now, EMR is just a wildly inefficient waste of taxpayer dollars and a black hole that sucks up doctors and nurses time with no benefit to the patient. Yes, the Feds want your data. But just like banking, access by employers and landlords will likely be criminal.

Security and privacy are not real big issues. Again, banking has this pretty well sorted out.

[Moses]

Originally Posted by Noah930

Yes, but part of the difference is that in banking, there are a finite number of users who access the system. They're all through banks. Done at the bank. There are only so many banks out there.

But in medicine, there are an exponentially larger number of medical providers: medical offices, therapists, pharmacies, hospitals, radiological centers, pathologists, labs, etc. Plus, people (doctors) will want to access the system remotely, as in from home. There will be far more people accessing the medical record system compared to a banking system. Keeping medical records private is going to be a far bigger challenge. Not insurmountable, but a bigger headache nonetheless. Look how hard it is to keep a celebrity's medical records private when they go to a medical center or hospital. Virtually any employee in the hospital can look up the person's labs or path reports on the hospital computer system. Making people sign in and sign out isn't a deterrent. What happens when any nurse, doctor, therapist, or lab technician anywhere in the country can log in and access anyone else's medical records?

In banking, stuff is done anonymously, by bank account numbers. There's no correlation between an individual and their bank account numbers. In medicine, stuff is done via name/DOB/SSN. And for the medical system to work effectively, that info has to be accessible even if a patient arrives in an ER, unconscious. Again, it's going to be a lot more complicated than banking. There's going to have to be a whole new infrastructure set up. And if people want to game the system by providing false identifying information at each ER visit, we're still stuck in the same boat.

Medical records numbers will be unique, encrypted and never associated with a patient name until it is accessed at the point of care with the patients permission. The models are out there. In your analogy banks are more accurately points of care and account holders are the patients. Security is not going to be a huge issue.