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Paperless

EHR Update (it is not pretty)

datalossCFrom NYT:

A 2013 RAND survey of physicians found mixed reactions to electronic health record systems, including widespread dissatisfaction. Many respondents cited poor usability, time-consuming data entry, needless alerts and poor work flows.

New York Yimes

According to the linked article physicians continue to be frustrated by technology and electronic health records. Like me, the author is a tech believer who sees the possibilities and wants everyone to be using technology. Indeed the potential benefits are amazing…yet.

So far technology has not done much to improve the delivery or the effectiveness of medical care. Physicians especially are exasperated with complex and hard to use systems. Rampant warnings designed to improve care are ignored. When every keystroke seems to result in a pop up warning the user just overrides them all and powers on.

There are two significant factors that are contributing to the problems.

First the EHR systems were designed to meet government specifications and mandates. They were not designed for physicians or patients. They are not designed to enhance work flow but to collect data. In dentistry we have had paperless electronic records for over a decade. (I went paperless with Dentrix in 2002). These records are easy to use and enhance both business and clinical experience for the dentist and the patient.

However what dental records lack is interoperability and standardized data sets. Even though I can create a complete electronic paperless record with Dentrix I cannot transfer that record if a patient moves out of town, sees another dentist or has an emergency hospital visit.

The second significant factor is change. Medicine is caught in the gap between comfortable old fashioned paper and the new electronic options. Many entities, doctors, clinics, hospitals and health plans are stuck doing both an electronic record and a paper record. Instead of making things faster and easier these hybrid systems make it worse. No one ever knows if the data they want is on paper or in a computer.

Getting past this issue will just take time and effort.

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