Comments on: Monday Morning Update 3/9/09

By: Sarah Corley CMO NextGen

Sarah Corley CMO NextGen — Tue, 10 Mar 2009 21:15:47 +0000

We have all seen doctors struggle with using electronic health records and we have also seen docs use them without any interruption in their eye contact and interaction with the patient. I think this is a combination of a number of things. The hardware and exam room set up: you have to be able to make eye contact no matter where the patient is and while tablets allow one to have something the same size as a paper chart that you can write on, you can also succeed with thoughtful placement of a fixed computer. Training: If you don’t spend the time learning the software and practicing before seeing patients with it, you will have to be looking down a lot so follow the recommended training and do at least 20 practice chart notes before you go live. Then you will find that muscle memory will lead you where you want to go and you can often find things much more easily than in a paper chart. You can also show the patient graphs of their labs, BMI etc that facilitate training and immediately print out appropriate patient education without rooting around in drawers and cabinets. Bring the patient into the computer along with you. Organizational issues: make sure that everything is not left to the physician to enter. Data should be entered by the lowest paid person capable of doing the job. So that might be the patient completing an online health history, medical assistants to gather the vitals and preliminary HPI information, front desk staff to order routine mammograms, etc. Software: You do need the software to allow you to take the history in any order that the patient presents it and you need it to be stable and not crash or blow up. Certification can never really test for what is functional as what is functional for me might be intolerable for you so we do have variety in the marketplace. Make sure when you look at demos that you have vendors run through the exact same script of something you commonly see without interruption before you take a deeper dive into features. That gives you a chance to look at the flow and how many clicks it takes, whether it drives you to take a history in one fashion or allows you to skip around. A lot of times at demos, we as physicians have some many questions that we never see that scenario end to end as it would likely play out in our offices.

By: Captain Wow

Captain Wow — Tue, 10 Mar 2009 16:47:13 +0000

“…actors can make you love them by just being whatever you want them to be…”?

True also with presidential candidates.

By: Jerry (IS Project Mgr)

Jerry (IS Project Mgr) — Mon, 09 Mar 2009 18:10:24 +0000

Seems to me that there a balanced view on the use of data input devices to support EMR’s by Physicians should consider both the needs of the Physician entering the data and the needs of the Physician involved later in the continuum of care’s need for that data. Physicians need to agree to these standards first and foremost. The rest of us just deliver to these standards with as reasonable and cost effective soltuion that ensure patient safety and care effectiveness as practical.

I agree with the well thought out comment by the SRSSoft CEO and the more matter of fact comments from Disbelieveing MD more that the bulk of design to date has been patient payor compliance driven and not necessarily patient care driven. I would encourage us “solution delivery” folks to not take lightly just how low the MD EMR adoption numbers are. This is not just the “rantings” of technophobic MD’s. They are quickly adopting the use of other data devices (iPhones for example) in very large numbers. They just have chosen not to adopt the solutions we have delivered to date in the same numbers; that points the issue is “our” solutions and not the end user. Let’s roll up our sleeves and fix the problems with the electronic care process holistically.

I for one am very optimistic we can do this (with or without the gov’t stimulus and preferably without)…

By: It's Not Easy Being Green

It's Not Easy Being Green — Mon, 09 Mar 2009 17:02:55 +0000

Re: Dennis Quaid comments… most entertaining piece I’ve read in some time. John Glaser look out! It’s probably because I agree with your assessment and it was nice to see someone come out and say what many were thinking. I’m not judging his motives or the frightening reality of what took place, but at the same time, I don’t think he’s ready to head up the HHS or FDA. I’m just not sure he would agree. As Inner Space said, the posiitive side of all this is the spotlight on patient safety.

By: Anonymous

Anonymous — Mon, 09 Mar 2009 16:36:42 +0000

I couldn’t agree more with your thoughts on Dennis Quaid. While the medical community could certainly see some improvements made…Doctors, Nurses, Healthcare IT professions and the like have one giant thing in common…we’re all HUMAN and unfortunately….humans make mistakes.