I would like to comment on Dr. Stuart Gitlow's letter entitled "Time not right for large-scale EMR project":
As a founder and chief executive officer of an electronic medical-record company started by a physician and developed with their unique requirements, I disagree with many of the comments made in this letter. The doctor states that as part of the purpose of an EMR, "any attempt at categorizing or minimizing, even within a diagnostic framework, results in the loss of information." I, as well as probably every other EMR vendor and physicians who use our product, would disagree.
EMRs such as ours can categorize information, display summaries of cross-sectional data, hide older data that are no longer valid (via comments such as "problem resolved" or "medication discontinued") and do a wealth of functions that contradict these statements. No data are lost, and if anythingare preserved and kept electronically better than you could on paper. A proper system will allow for annotation of past data, the ability to "hide" nonrelevant or resolved problems or symptoms, as well as other things in contrast to what Gitlow has stated.
Our program, as well as many EMR programs, provides plenty of space for the physician to document free-text notes. You could build an entire patient-chart note just by using our "add note" free text boxes, even using voice recognition. So a wealth of real-time data from doctors' observations of a patient can be captured in a variety of means. To make the statement that EMR-based reports are "worthless" is a strong statement that I believe is not based on factual reality in the face of the many good products on the market these days that do provide these features.
Error rates can be decreased by legibility of reading reports that are electronically generated (as opposed to "chicken scratch" doctor notes); drug-drug interaction checking; checking for proper billing codes based on documentation levels and many other ways.
Not all electronic charts come in a single flavordo a search and you will find a variety of EMRs for every physican specialty that are uniquely tailored to that specialty and provide tools that are (or should) be customized for that type of practicing physician. Maybe in the field of psychiatry, the offerings are vanilla. But in our industry, ophthalmology, the sophistication is extremely high, with importation of diagnostic images and data into EMRs, connection to outside laboratories and e-prescribing.
The argument over cost of systems is also a weak onea good EMR will help you become more efficient, allow you to code better (increasing return on investment and payback of the system), and in the long run, allow you to have streamlined and consistent documentation that can be shared, searched and reviewed quicker than "chart pulls," that are cumbersome and can only be done by one person at a time. What happens if your chart room catches fire? Off-site or portable computer backups of EMR patient data prevent that.
EMRs are ready for prime time, you just have to find the right one for your practice that meets your needs. Gitlow's letter does not help the advancement of technology in a field that is very far behind technically compared with other industries, and could very much use it.
Ryan LevacyPresident and chief executive officermdTeknixHouston To submit a letter to YOUR VIEWS, click here. Please include your name, title and hometown.