Showing posts with label EHRs. Show all posts
Showing posts with label EHRs. Show all posts

14 June 2013

News Media Is Schooling Doctors


I don't know whether to laugh or cry about this blog by Dr. Wes. What Dr. Wes is saying is true. It is in almost every daily newscast and in the printed media. I must wonder at the same time if this is not part of our current administration's goal to keep doctors off balance while changing so much of their lives with the roll out of the current healthcare law. As a patient, I feel like answering some of the points Dr. Wes says the media is trying to school him.

At the same time, what Dr. Wes is saying about the way he thinks (I hope tongue-in-cheek) is that all doctors should turn their head away from the computer screen (not a bad idea). His next suggestion will make patients wonder where he is coming from when he says hold the patient's hands and look into their eyes. If any of my doctors were to do this, I would probably be out the door very fast. Next, he says doctors are to listen to their concerns, which many doctors do not do. They have their cookbook medicine to follow and finish before their time with us out runs out.

The next two items he lists are over the top and I would complain if he put himself in my place and do a thorough physical exam at every appointment. Most of the time, patients just want communication and an exam maybe once a year, unless it is necessary because of what the symptoms are or may indicate. Having constant empathy and insight is over the top and a little sincere communication here would go a long way. The doctor's assistant, sometimes a nurse but often a certified nurse's aid, normally handles reading back medications.

Some patients do need written instructions in fifth grade English, but even then, some patients will not understand. These patients should be encouraged to repeat back what they have been told. A doctor should consider escorting the patient to the checkout area where normally the next appointment is set up and instructions for lab work at the next appointment are spelled out on the appointment card. The following area I have seen in some media news stories and I wondered why every doctor needed highly skilled and educated assistants. Now I know that some doctors do need their services because to the requirements of the appointment and in some outpatient services. Most other doctors will not need them.

Rather than quote Dr. Wes, I would say his blog is excellent and he does need support for the position he takes. I poked a little fun at him above, but in reality, the media and even some of his colleagues are not supporting him. They want more monies for not doing some important aspects of their profession. See my blog here. I will quote this and it is about the requirements put on doctors by the electronic health records. Dr. Wes says, “We move as fast as we can to remain productive, because that's what's REALLY valued in healthcare these days. So is patient loyalty because that's what keeps them coming back. But in the process of growing loyalty, we increasingly have to document everything or other payers think it doesn't happen. So we type. And click. And type. And click. And print. To get paid. Talk about a communication and empathy buzz-kill!”

Please take time to read the blog by Dr. Wes. I am surprised that it received few comments and some as anonymous.

24 May 2013

EHR Dissatisfaction - A Tech or People Problem?


We have been hearing from doctors and others about how much problem they are having with the electronic health record (EHR) systems they are being required by law to use. Having watched some of my doctors use one system, as a patient I can sympathize. If they don't want to come back later and try to remember information, they need to sit and click, and click, ad infinitum. In many ways, I do not understand as I have operated computers and programs. Some are labor intensive, and some are almost interactive, but unless I was working on a special project, I had time to keep up with other activities. Then to have medical programs that are so proprietary and the information so accessible to electronic thieves, makes me wonder if this technology is worth the expense.

Now, we have a blog by a person working on the other side of the problem and making a statement questioning whether it is a tech or people problem. According to this blogger, it is a people problem because the organizations are treating implementation as a purely technological issue when in reality it is a workforce issue. She is saying that organizations did not do their homework and have workforce training and readiness for the installation and implementation.

According to this blogger, most organizations do not have the workforce necessary with the training to make proper use of the programs. If only it was that easy! Most practices are being pushed to their financial brink and some hospitals are actually over the brink. To hire and have the workforce available is not economically sound and would bankrupt many organizations. Yet these programs are mandated and to receive monies organizations need to have them installed. And the tech organizations selling these systems could care less that their programs may not be as efficient and safe as the buyers need.

The 2006 publication “Building the Workforce for Health Information Transformation” by the American Health Information Management Association and American Medical Informatics Association stated: “A workforce capable of innovating, implementing, and using health communications and information technology (IT) will be critical to healthcare’s success. Conversely, without such a workforce, implementations will fail or could even cause harm.” What these associations don't understand is how close to the edge many medical practices and hospitals have been operating.

And then to blame them for not having the trained workforce is the height of ignorance and lack of caring on their part. This is evolving into a blame game and patients will be the losers. I feel the tech people did not do a proper assessment before completing their work.