I am simply posting a link to this essay by Virginia L. Hood, MBBS, MPH, FACP, President of the American College Of Physicians (ACP) with only one comment:
Electronic Medical Records have Yet to Fill Their Potential
http://www.acpinternist.org/archives/2011/10/presidents. htm
From the October ACP Internist, copyright © 2011 by the American College of Physicians
Read the whole essay at that link.
Nearly every issue mentioned is addressed extensively on this blog since 2004 and at my educational website "Contemporary Issues in Medical Informatics: Common Examples of Healthcare Information Technology Difficulties" at this link. The latter site was started not just last month or last year, but in 1999.
My only comment is that I was more than a decade ahead of my time in recognizing and writing about many of the issues she discusses. Sadly, few were listening; now physicians are not just being encouraged, but in fact prematurely coerced to adopt this technology - in the deficient state as it exists today - by HHS. Tens if not hundreds of billions of dollars have been earmarked for our 'National Program for IT in the HHS.'
Ready, shoot ... aim.
-- SS
[Note] In reality, I am a critic of the use of poorly designed, poorly implemented and poorly managed clinical IT in hospitals.
They are also alienating patients. I fired a doctor today who preferred to look at his computer screen than look at me (his patient). Curiously, my PCP is quite able to use her practice's EMR without harming the quality of the interaction. In her case, I value the EMR because the on-call physicians are able to access it and have some idea of my history before talking with me by phone.
ReplyDeleteWow. Absolutely on target. One thing Dr. Hood seems to not understand is that the money for the EHR is spent and now part of the vendor's profit margin. There is no money for extensions or enhancements as described.
ReplyDeleteScot,
ReplyDeleteYou should be flattered that she read your work and used the theses and concepts you have developed over the years.
She is at the University of Vermont, home of the medical record SOAP note guy Dr. Weed. Wonder what he has to say about the UVM EMR go live?
The Fletcher Allen Medical Center uses Epic's PRISM. Here is the conclusion of an Honors Thesis at its nursing school:
http://www.uvm.edu/~honcoll/S10_Thesis/Stuart-Shor_Katie%20S10.pdf
"The Implications of the Electronic Medical Record on Nurse Bedside Shift Hand-off"
Katie Stuart-Shor
University of Vermont
College of Nursing and Health Sciences
Honors College Thesis
January 20, 2010
“…The electronic medical record has
disrupted the practice of
bedside report on this general medical unit; detracting from a practice
intended to support patient
centered care…”
And here is what the UVM web site bloats:
http://www.fletcherallen.org/for_providers/electronic_health_records/
0. Enhanced Patient Safety and Quality of Care – Automatic checks in the electronic system will safeguard against undesirable medication and allergy interactions and incorrect dosage amounts, improving patient safety.
0. Increased Efficiency and Accuracy – Using an electronic health record eliminates time consuming, potentially duplicative and error-prone paper recording of patient medical information, and legibility of treatment orders and other information entered into the
medical system will be improved._
care in a fast, comprehensive and consistent fashion.
0. Leading Technology – Epic, the software vendor for PRISM, is the leading electronic health record vendor in the US and is utilized by
such respected health care systems as Cleveland Clinic, Geisinger Health and Kaiser Permanente, among others.
REALLY now? C'mon man
It is much worse than she describes. Keep in mind that the ACP has imbibed HIT kool aid for years, so these commnent reflect the tip of the iceberg.
ReplyDeleteUVM must have been in mayhem, as in the UK Milton Keynes Trust. But Epic is still selling.
Anonymous October 14, 2011 7:07:00 PM EDT writes:
ReplyDeleteCuriously, my PCP is quite able to use her practice's EMR without harming the quality of the interaction. In her case, I value the EMR because the on-call physicians are able to access it and have some idea of my history before talking with me by phone.
A document imaging system could do the same thing, for far less cost and with no disruptions.
The problem is, today's health IT is not done well. It is largely too primitive and confusing in its user interaction, and too complex it is data granularity to actually support clinical medicine well.
-- SS
Anonymous October 14, 2011 10:14:00 PM EDT writes:
ReplyDeleteYou should be flattered that she read your work and used the theses and concepts you have developed over the years.
I don't know if that's the case; it's easy to come to the same conclusions independently. All a clinician needs is a pair of open eyes and a bit of critical thinking.
And here is what the UVM web site bloats:
Boasts? Bleats?
I expect nothing less of P.R. sites. What I do not expect of P.R. sites is objectivity.
-- SS
I guess it would be too much to expect Dr. Hood to acknowledge the ACP's long history of fact-free EHR advocacy, which has been a major factor in saddling docs with unusable, expensive IT.
ReplyDeleteHer article contains several links to other parts of the ACP web site that maintain this relentless pro-EHR publicity campaign.
Anonymous October 18, 2011 10:44:00 AM EDT writes:
ReplyDeleteI guess it would be too much to expect Dr. Hood to acknowledge the ACP's long history of fact-free EHR advocacy, which has been a major factor in saddling docs with unusable, expensive IT.
Yes and yes.
-- SS
I had a doc that has never met me proclaim me fine over his computer screen. Days later one of the best cardiologists in the country told me to go home and conserve my energy till I could get in to see somebody and that sometimes people die waiting for answers.
ReplyDelete