Comments on: Few out-patient physicians have access to full-function EHR systems

By: TAMZIN rOSENWASSER

TAMZIN rOSENWASSER — Wed, 25 Jun 2008 22:11:50 +0000

THERE ARE NO “GOALS” OF THE “US HEALTHCARE SYSTEM”. THE GOALS ARE THE GOALS OF CENTRAL PLANNERS, WHO DO NOT DO OUR WORK.

CONVENIENCE AND EFFICIENCY ARE ONE THING, AND CENTRAL DATABASES ARE ANOTHER.

RESTORE CONSTITUTIONAL GOVERNMENT. nOTHING IN THE CONSTITUTION GIVES THE GOVERNMENT AUTHORITY OVER MEDICAL CARE.

By: A. E. Miller, MD

A. E. Miller, MD — Tue, 24 Jun 2008 14:54:46 +0000

A Note for Dr Orient,

Hello, Jane, I know you’ve read a few of my essays in the past and I thought you might appreciate a few recent thoughts from a column in the Idaho Medical Assn IMAges newsletter:

http://www.idmed.org/public/components/societytools/admin/viewNewnews.asp?newsjob=ArticleID&ArticleID=9109&ArticleName=%3Cb%3EQuack+Tracks%3A+The+Database+Blues%3Cb%3E

By: zvi herschman

zvi herschman — Tue, 24 Jun 2008 12:28:34 +0000

If they want electronic medical records, give the patient a $10 stick drive with 2 gb of storage to keep and every doctor with a simple computer and operating system can load on his notes, labs, x rays, etc. and the patient can take it with them where ever they go. Full privacy is in the hands of the patinet. It can be translated into any langauge, given to whom ever the patient decides to trust and no doctor has to invest in expensive programs and their upkeep. If you follow the ones pushing for mandatory EMR’s and follow the money, you will quickly realize tis is a government mandated jobs program

By: John Kelly, M.D.

John Kelly, M.D. — Tue, 24 Jun 2008 11:34:24 +0000

I have been studying this issue for many years, basically waiting for a system based on open standard, commercially mainstream product that is affordable and intrudes the least on the doctor-patient encounter. I continue to use pre-printed hand-written templates, at times assisted by a scribe in the exam room, with the templates generated in Excel, which is not open standard, but is well-supported commercially. I would love to see Palm develop a menu-driven template-oriented note that follows the doctor’s typical work-flow, or see a Google Health product that would have many of the desired features, including the ability to beam my note to the patient after the encounter, as Palm could conceivably offer. Either could let the patient generate text that outlined the medical history.

Current hand-helds could easily hold years of text notes, and would not divert the doctor’s eye-contact like laptops or monitors do. Also the possible decentraliztion of the medical records into the hands of the patients as is done in the military where active duty service men and women bring their records to their new doctors after re-assignment would avoid some of the problems of centralized bureaucratic control.

The federal government’s record of handling medical and other records securely is not good, and yet it will soon force us to face an unfunded mandate to secure our workplace from identity theft with posible large fines for poor demonstration of compliance efforts, which many doctors don’t even seem to know about…

By: Ed Davis, DPM

Ed Davis, DPM — Tue, 24 Jun 2008 02:02:42 +0000

The advent of ASP’s (online application service providers) obviates the need to purchase expensive legacy systems — clinic based servers, IT support/departments, software updates, hardware.

ASPs charge a monthly subscription fee. The software resides on the server of the ASP which is responsible for maintanance, software upgrades,etc.

Since there is no upfront investment, the risk to providers is minimized.

By: Dorothy Merritt

Dorothy Merritt — Tue, 24 Jun 2008 01:58:56 +0000

One of the best things I ever did was start to invest in a EMR 21 years ago. I started with billing and then added the scheduler and medical record about 15 years ago. It was a big investment then but, it is worth 5x more now-one of the few things that has appreciated in medicine. I could never afford it now but now that I have it, I would quit rather than ever go back to paper records. I am 10x more efficient and need less people to do my billing, coding, and pulling charts. Also, there is no big file room to pay for. I can email records without printing them out. I can email results to patients on a secure email and avoid the $1000 of postage our multiperson group used to pay for mailing results. My notes are much more organized, readable, and valuable…Get connected,,,its better for you and costs less in the long run.