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EHR, HIE, Random Rants

Redundant Conversations

I’ve been having an interesting couple of days with some of my colleagues discussing what products in the California market are worthy of being called EHRs (Electronic Health Records). Some really interesting opinions.

One of the points I tried to make was that people don’t agree on why EHRs should exist or why doctors should use them. From a federal point of view I made the point that an EHR was supposed to enable the following:

  • Empower the clinical conversation among providers and the owners of the health record; the Consumers.
  • Reduce duplicative procedures among providers.
  • Reduce errors.
  • Provide the feds with a means to tell good providers from bad ones.
  • “Flatten the cost curve”
  • Empower clinical decision support

I think any one of these points would be sufficient justification for the adoption of an EHR. But the clinical folk don’t get this. A little story illustrating this is in order.

I recently escorted a family member to a surgical consult. It was a second opinion actually for some minor corrective work. Nothing major here but we did have to travel a number of hours out of our area for a highly recommended surgeon. We consulted this physician because of a very spotless track record and a high success rate. Its clear he knows his business.

We got into the office and went into an examination room for the initial intake. There was no ability present for us to transfer records from the first consultation which was extensive. The nurse was personable and complete. She actually spent a good ten minutes ferreting out drug interaction info, particularly reactions to meds and anesthesia at both a previous surgery and the dentist. This seemed wise. It also seemed, to me, to be pretty useless. My relative couldn’t tell the nurse what anesthetics had been used or the dosages. It would have been nice to have been able to call up an EHR from both doctors and see exactly what medications had been used and what dosages had caused what reactions. I suspect your experiences with surgical detail has also been rather vague too.

So, one of the questions my relative asked the surgeon was “What EHR do you use?” He laughed and poked fun at the current president as well as stating ” Oh I have a great EHR! Its called a fax machine!” Point being, of course, that he saw no reason why he should be burdened with an EHR. I’m willing to bet, since this doctor works out of a private surgical center and not a hospital, that after the surgery my relative will be no closer to being able to tell anyone anything substantive about the treatment.

This attitude has been pretty consistent among private providers be they dentists, specialists or primary care physicians whenever I check. They just don’t care.

What’s your experience been like in this area? Are you asking your clinical providers if they are using an EHR yet?


About barkie19

I'm a Healthcare Information Technology consultant who happens to specialize in the Public Behavioral Health world. Things have been at the status quo for a while and I believe its time to change the conversation. Talk to me, please.


One thought on “Redundant Conversations

  1. It is a very interesting observation. I have found this attitude even within a section of the provider community that has ‘reluctantly’ adopted EMR.

    Reasons range from – I have to do it eventually, why not now?, I can use the incentive money, it should help the billing folks, and so on.

    After a drink or two, they will tell you exactly what the surgeon said.

    Posted by Chandresh J. Shah | February 17, 2011, 2:17 PM
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