NY Times: Rural Doctor Finds Benefits in Electronics. I know all the experts have a thousand reasons why “it’s not that simple,” but I do this stuff all the time in my day job and I don’t know what’s such a big freakin mystery.
Having data online works. Look: that’s how we write this blog, or find airfares, or anything else. Just use a browser.
Here’s how it plays out:
[the doctor says] “I can always look at the records by Internet, whether I am seeing patients at the nursing home or a clinic or the hospital, or even when I’m as far away as Florida. The change has been tremendously beneficial for my productivity.”
Patients are appreciative, too. Kagay Wheatley brings her 97-year-old neighbor, Charlotte Hayes, to Dr. Brull for blood tests every few weeks. “We do not have to sit and wait while the nurses search for the records,” said Ms. Wheatley, a retired school board aide who is also a patient of Dr. Brull’s. “They find the information right there on the computer, and when we leave, we get a printout of what we did and what she said.”
Seriously, if the geniuses running things today can’t figure out how to get this done, the rest of us will just go off and do it on our own. It’s not that difficult.
Sociologically it make take a generation change. The doctor in this story is 37, and the generation coming up through med school today grew up online, so there’s no resistance there. Perhaps the “I prefer paper” generation will retire gently and the new way will be adopted by the up-and-comers.
Me, well, years ago I got me a doc who’s really online. We like it that way. Heck, when I got my out-of-the-blue bad-news x-ray, the other doc called him, and right there at home he pulled up my images on this computer screen. How sensible is that?
My only question for the Times is, they say 42% of family doctors have some sort of online records. I thought adoption of electronic medical records was really in the single digits. Let’s see if we can get some experts to speak up. (Perhaps there’s a big difference between “adoption” and “some sort of.”)
Just had a great call with David Kibbe, the IT advocate at AAFP (the organization cited above). He says he’s been pushing their 30,000 members to adopt these systems, and indeed 40%+ have done so. BUT, industry-wide, that’s a drop in the bucket compared to the 800,000 total docs in the US, almost none of whom are using such systems.
A picture is worth a thousand words:
From “Health Information Technology and Physician Perceptions of Quality of Care and Satisfaction”. The Commonwealth Fund”, January 28, 2009.
Denmark family practices have adopted EHR almost unanimously (98% of practices) and the Danish government is working to develop a worldwide standard for EHRs. In the US, it looks like the VA is doing similar work, because they need to have interoperability across continents.
Weird that the “most powerful” country on earth is so late to this game. While some professionals here are still discussing if ICD-9 (over 30 years old system) could be used for a while longer the rest of the world is actively working to develop IDC-11 (revisions will be made following web 2.0 principles)
A major problem is the perception that most electronic system for office practices function at this level. The truth is far from this reality. I’ve used near paperless office IT combos since 2001 and have been able to look up pt info, but this didn’t have a good interface with labs, hospitals, emergency departments, etc.
Good health IT is great and a real boon, but most health IT out there is very expensive garbage that helps docs bill more for their services – hardly the goal we’re after here (though I do call for more support of effective primary care given the studies demonstrating the benefit to society).
My colleagues are justifiably slow in adopting HIT. You’re right that this is not rocket science, but most programs out there take weeks of training and tens of thousands of dollars. This is an indication of the non-friendly nature of the systems and the rapacious instincts of the vendors.
There are some systems that are indeed intuitive and very cheap, and it will take some time for them to penetrate the markets. I just hope that the well-connected big boys don’t use their Washington muscle to shut them out of the running (as is likely with the CCHIT certification track).
I’d like to know who the “well-connected big boys” with “Washington muscle” are. Anyone’s welcome to drop me a private note.
I’m not someone to burn things down, but I sure have a strong commitment to patients getting better treatment, and thus a commitment to helping physicians be more effective at doing that. :–)