Electronic Medical Records, Scribes, and Obamacare

[seoxeee]

The I-7 Intel processor on my computer is 260 times faster than the processor on my first PC, but I don't write any faster. Although pretty much everyone has a computer these days, I can't say most people are all that much more productive. With a few notable exceptions, like news, some medical billing software, financial scams and gossip, the outlandish predictions of phenomenal productivity improvements from the computer revolution have not panned out. This is not to say I want to go back to a pen and paper, but only that technological change leads in unexpected directions.

The proponents of Obamacare are making the similar claims of cost saving and productivity gains for electronic medical records (EMR). If you listen closely to the rhetoric surrounding Obamacare, the only concrete proposal for lowering costs seems to be the use of EMR's which will both magically lower costs and avoid mistakes. It is remarkable to me that almost everyone in government, from the President on down, is affirming the benefits of this technology which is both unproven and in the early stages of development. A small group of economically motivated vendors, with no definitive studies, have sold EMR as a panacea to all of the problems of health care in America.https://tinyurl.com/a7ra9dty

I cannot tell you the frustration I have personally experienced trying to obtain and collate information from masses of handwritten, illegible and disorganized patient charts. As a Radiologist, I was frequently dependent upon unreadable, scribbled requisitions for a scrap of justification upon why I was doing an expensive or dangerous examination. However, it is unclear to me that the present EMR's are a substantial improvement. Although promising, such systems come with substantial cost, significant learning curves, and new difficulties.

Paper charts are low tech with many problems, however, they have been used for years and systems have evolved for dealing with them. New high tech EMR systems have great potential, but transitions are difficult and need to be done properly.

Doctors and nurses find entering the data with EMR's frequently takes far longer than paper, and results in less time for patients. The referenced article today is about how doctors are hiring people(scribes) to do the actual data entry for them. We used to use transcriptionists just for this purpose, but got rid of them because they were too expensive. Seems like progress to me.

From my experience, retrieving information is even more difficult with an EMR, as complaints generally center around data entry. Such developments will be needed for productivity enhancement. I am waiting for large scale studies showing either improved efficiency, fewer errors, or cost savings. I may be waiting a long time.