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As a family medicine physician who until recently was working for a large hospital system and has experience after going through three electronic health records I can endorse the issues that Ms.Sinsky so aptly puts forth. This problem is common to all enterprise electronic health records at this point in time.
The basic problem is that electronic health records have had two masters-the clinical part of the record which is important for patient care and the billing part of the record. Which one do you think has won out?
The other overriding issue is how physicians and systems are paid. Most systems are still paid on an RVUs/piecemeal basis. The dirty little secret is that electronic health records could be excellent at “not seeing patients” and taking care of populations. By this… more »
I am a family physician with fairly extensive experience with patient generated health data. Until recently I was working for a large hospital system. I exchanged email with patients over the past 12 years. I also used software called instant medical history whereby patients could take an interactive history and this could be part of the healthcare record. For most of my time in the hospital system, I was very frustrated as I was given little encouragement and virtually no help especially from the information services point of view. So here are a few observations/suggestions:
1. The inability of electronic health records and data in general to communicate with different systems in United States has been a disaster in my opinion. There has been very little incentive for electronic health record… more »
Funny you should ask-
About two years before I stop working at the hospital system, I saw patient who was transferring to me because of insurance issues from the other large group in town. The interesting thing about this is that the hospital and the other large group in town used the same electronic health record and it was still impossible to transfer data from one system to the other even though both records were the same. (Apparently the records were different enough and customizable enough that it was impossible to transfer digital data). What the heck is going on. Disgraceful.
Sure, here is my suggestion. Since most of the large players in the industry supply enterprise systems which are very costly, my suggestion would be to withhold Medicare money from hospitals who have products… more »
I do not personally have any experience with organizations that use computers effectively to take care of populations outside the office environment, however from what I have read organizations such as Kaiser, health Cooperative of Puget Sound etc. are much further along in this process as they seem to have a logical, system-based organization that are well aligned.