Finally something I’m actually qualified to weigh in on! I’m the lead UI developer for an EHR software (not saying which one or getting into details–it’d be pretty easy to figure out my identity).
First, to be fair, it’s possible that the software they’re using is genuinely terrible. They don’t say which EHR. I’ve heard this kind of thing from providers before, though, and it’s usually that they don’t know how to use the software. From the way the article describes the provider, it sounds like they’re stuck in paper and don’t want to learn a new way of doing things. On the one hand, fair enough–patient care should be their primary concern. On the other hand, patient care is so much easier, faster, and more accurate in an EHR.
In my EHR you select a patient and can get a full visit summary on any visit the patient has ever had with a couple of mouse clicks. Immunizations, clinical notes, radiology, goals, problems, vitals, education–everything that happened during the visit. There are built-in tools for reminders that automatically notify you of things that are important for the visit based on previous visits, contraindication checks for medications, tracking of fluid balance, integrated documentation for clinical reference and distributing to patients, etc, etc.
That’s not even to mention things like compliance for clinical quality measure reporting, integrating with state immunization registries, easy export of data to external facilities (eg, CCDA), using digital signatures for non-repudiation of controlled substance prescriptions, automagically pinging requests and data around to the different departments, etc. So many things that used to rely on a human squinting at a paper now just happen, with a built-in audit trail.
As for billing: we (developers, testers, and project/product managers) HATE billing. It’s a necessary evil, but we package it off as a separate plugin. It can pull procedure codes and the like from the database to do its job, but to suggest that billing is the only reason to use an electronic health record is astoundingly ignorant. Patient care is the primary concern of everyone who actually has hands on the application. Most of us are former providers who just happen to be alright at coding.
Thank you for chiming in on the slightly spurious billing claim. Yes, billing and charge codes are woven throughout EHR systems but that’s just because everything we do in health care costs time/money. It’s as much about cost tracking as cost recovery.
We measure what we treasure however and if you look at the structure of any EHR, they are steadfastly patient-centric. Billing is ubiquitous but it is more like tinsel on a Christmas tree, sort of draped lightly over and connecting everything. Pick off the tinsel and the core patient care features are unaffected.
It will take years to see the effects in large scale but I like the features that allow patients to see their test results the minute they are released. As a patient myself, it gives me a feeling of having a bit more ownership of my own healthcare.
I was intrigued to learn recently that better EHR use a patients highest education level to tailor the way genomic test results are presented in the patient-viewable chart. The same results are reported to anyone but apparently patients with higher education levels will take positive actions when provided with sufficient depth of background information. Conversely, too much background info can be off-putting for others and reduces proactive behavior changes.
I get it, it’s really easy to be cynical about health care especially in the USA where it is kinda bad in many ways for no good reason. But at least pick the right things to complain about.
Finally something I’m actually qualified to weigh in on! I’m the lead UI developer for an EHR software (not saying which one or getting into details–it’d be pretty easy to figure out my identity).
First, to be fair, it’s possible that the software they’re using is genuinely terrible. They don’t say which EHR. I’ve heard this kind of thing from providers before, though, and it’s usually that they don’t know how to use the software. From the way the article describes the provider, it sounds like they’re stuck in paper and don’t want to learn a new way of doing things. On the one hand, fair enough–patient care should be their primary concern. On the other hand, patient care is so much easier, faster, and more accurate in an EHR.
In my EHR you select a patient and can get a full visit summary on any visit the patient has ever had with a couple of mouse clicks. Immunizations, clinical notes, radiology, goals, problems, vitals, education–everything that happened during the visit. There are built-in tools for reminders that automatically notify you of things that are important for the visit based on previous visits, contraindication checks for medications, tracking of fluid balance, integrated documentation for clinical reference and distributing to patients, etc, etc.
That’s not even to mention things like compliance for clinical quality measure reporting, integrating with state immunization registries, easy export of data to external facilities (eg, CCDA), using digital signatures for non-repudiation of controlled substance prescriptions, automagically pinging requests and data around to the different departments, etc. So many things that used to rely on a human squinting at a paper now just happen, with a built-in audit trail.
As for billing: we (developers, testers, and project/product managers) HATE billing. It’s a necessary evil, but we package it off as a separate plugin. It can pull procedure codes and the like from the database to do its job, but to suggest that billing is the only reason to use an electronic health record is astoundingly ignorant. Patient care is the primary concern of everyone who actually has hands on the application. Most of us are former providers who just happen to be alright at coding.
Thank you for chiming in on the slightly spurious billing claim. Yes, billing and charge codes are woven throughout EHR systems but that’s just because everything we do in health care costs time/money. It’s as much about cost tracking as cost recovery.
We measure what we treasure however and if you look at the structure of any EHR, they are steadfastly patient-centric. Billing is ubiquitous but it is more like tinsel on a Christmas tree, sort of draped lightly over and connecting everything. Pick off the tinsel and the core patient care features are unaffected.
It will take years to see the effects in large scale but I like the features that allow patients to see their test results the minute they are released. As a patient myself, it gives me a feeling of having a bit more ownership of my own healthcare.
I was intrigued to learn recently that better EHR use a patients highest education level to tailor the way genomic test results are presented in the patient-viewable chart. The same results are reported to anyone but apparently patients with higher education levels will take positive actions when provided with sufficient depth of background information. Conversely, too much background info can be off-putting for others and reduces proactive behavior changes.
I get it, it’s really easy to be cynical about health care especially in the USA where it is kinda bad in many ways for no good reason. But at least pick the right things to complain about.