lets get a grip

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What's Happening Now

April 14, 2013 8:04 pm

I do not understand why the government of the US is involved in this process. The US constitution, Article 1, section 8 delineates the role of govt in the arts and sciences: “To promote the Progress of Science and useful Arts, by securing for limited Times to Authors and Inventors the exclusive Right to their respective Writings and Discoveries;”
The founding fathers clearly hoped that the govt would stay out of affairs that are best solved by the private and financial forces which are, by nature, more responsive to the happenings and influence of the consumers, individuals and businesses.
Already, healthcare is encountering problems due to the fact that it has been separated from standard influences of our culture.
Patient decisions are minimally inpacted by EHR. They are… more »

…majorly impacted by the physician taking time to listen to their concerns and answering their heartfelt questions. Trust and listening skills are not built by EHR.
Furthermore, an extremely important part of a physician-patient relationship, compassion – sharing in our patients’ suffering – is not achieved through or facilitatied by an EHR.
Thus, ‘meaningful use’ is more about what is important to third parties than to the physician and patient.

Below, hrdahlman writes: “It is key to patient engagement for them to own not only their information but their health.”
I summarize for my patients’ visits with notes we have made during our discussion and pictures that I have drawn and links that I have recommended. More important than handing them a copy of their record is that they have access to me when changes occur and questions arise. I am accessable partly because when a patient departs, my notes are already done and I am free to answer a call or move on to the next patient. My colleagues are fatigued by typing into their EHR’s during, after, and during the night of their visits. Fatigue does not make for a friendly and compassionate physician. That is much more ‘meaningful’ than an electronic record. It also generates higher quality care (as big business’ employee benefits departments are coming to realize.) « less

April 15, 2013 12:59 pm

Correct, in that I do not think it helps primary care providers deliver quality compasionate care. My system is perfectly adequate currently. From the exam room I can link to our hospital’s data base. I receive faxes from the specialists’ consults the same day. I receive lab and xray from outside facilities in 1 day. An EHR would just add more hastles to our day. I already e-prescribe, e-bill and have e-medicine lists, allergy lists and diagnosis lists. I have medication crosschecking prescribing modules and I have Up-To-Date module for current care protocols. The only thing I don’t do is e-records.
I admit that EHR would be available to the specialists and that would facilitate their record keeping, but as a solo primary care practice including OB and inpatient care… more »

…as well as 30% of my time being spent on regional and national efforts, I cannot afford the time or expense to launch and pamper an EHR for the sake of the specialists charting. I provide them with a succinct medical record when referals are made. They are charging huge fees for 15 – 60 min spent with the patient. Yet they are heading to the parkinglot at 4:30 PM while I am there till 8-10 pm most nights and later when on call. Primary care small practices cannot afford the expense. There is no return on investment. My primary care colleagues that have started EHR’s and their staff have suffered greatly and some never even received the reimbursements to which they were entitled.
I did not intend to whine, it just does not make sense for my staff, my patients or my sanity. My patients receive excellent, up to date, compassionate care with time available for listening and excellent access to our office.
I do not see how an EHR will improve that.
If it is true that the marketplace should decide, we are getting requests every day from patients wanting to switch from practices with an EHR to our practice. So it would seem that the consumer doesn’t see the benefit either. « less
April 15, 2013 12:05 pm

Hi lets get a grip and welcome to Planning Room.
ONC’s work on EHRs and health IT is governed by HITECH Act regulations. The Health Information Technology for Economic and Clinical Health Act (HITECH Act or “The Act”) is part of the American Recovery and Reinvestment Act of 2009 (ARRA). For more, see:
It sounds like you don’t think Health IT can assist providers in delivering compassionate care. How, if at all, do you see such systems being valuably utilised by healthcare providers in order to improve their service to patients rather than draining resources and time?

April 15, 2013 7:57 pm

Thank you for your reply, lets get a grip. Do you have any suggestions for what ONC can do to enhance the ability of small primary care practices to deliver quality compassionate care and encourage patients to become more engaged in their health care?

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