Aaron Berdofe, MHI – Health Informatics

Check out this video of the new Dr Chrono eRx application on the iPad.  I love my iPad and try to hide it everytime I walk into a physician office because inevitably I get the question: “Does MEDITECH/LSS work on the iPad.”  I’m not in marketing or sales for MEDITECH or LSS and so I give them the honest answer: Absolutely not.  I wanted to point out one of the “cool” things going on in the EMR world, because it still makes me ask the same questions everytime I see something new.  In this case, regarding prescriptions:

Why does it take a full minute to send a single prescription?

Anyone who wants to implement an EMR* to make all of their inefficiencies go away and find greener grasses in their pasture has been misled.  EMRs displace time hogging activities.  They don’t get rid of them.  Usually, more burden goes on the physician which is why they make such a big stink about them these days. 

EMRs take paper world processes and make them electronic.  This amplifies both efficiencies and inefficiencies, sometimes to an exponential level.  Unfortunately, not a single ambulatory EMR creator (I can’t speak for the hospital side) has really taken two steps back and focused on the jobs that needed to be completed in a physician practice and the outcomes desired.  Instead, they’re told how physician practices have operated for the past and assume that’s how they should operate in the future.  Physician practices’ success is directly determined by their patient volumes minus costs.  Time displacement and a big financial investment don’t help either of these measures.  If you still think EMRs will save you time, do a search for any study that says so.  You won’t find.  I don’t think even EMR vendors are willing to put that in writing without a list of caveats although they like to say it a lot.

Therefore, if you truly want to cut costs and vastly improve your physician practice’s financial and patient health outcomes, an EMR probably will not get you there by itself.  An EMR will allow you to better record patient visit information, make sure high risk patients are returning when they are supposed to and give you access to mountains of medical and financial data that can be used to analyze the overall population health and locate your operating inefficiencies.  Nurses and physicians love the fact that they don’t have to physically search for patient charts anymore after they’ve gone to an EMR.  Every single one of my clients shares this singular praise.  Then they complain about how much time it takes to input information into their system.  These are the realities that you have to frame the implementation project around. 

*I realize that the HITECH Act has declared electronic systems that work according to their standards to be Electronic Health Records (EHR), but these systems are recording the health of patients or patient populations.  They record the medical interactions of patients and patient populations.  The vast majority of visits to a physician office are to fix something that is wrong with a patient, not maintain something that is right.  Semantics? Yes.  But words are important.