In response to reader commentary, "EHRs don't save Texas doc time, money or paper":
To be honest, the writer is one of the reasons for the slow adoption rate of electronic health records. Frankly, his attitude is the major problem. He states that the EHR did not save him time, money, paper, etc.
So I take it that sticking with a completely paper-based record system is somehow better in his mindone that does not allow for easy record sharing, better documentation and coding; the ability to check for drug interactions; the ability to electronically order laboratory results and medications; the ability for multiple caregivers to access the patient's chart at any given moment (as a paper chart has only one instance, and cannot be "looked up" remotely or viewed at the same time). If we follow his argument, medicine will stay stuck in the Stone Age.
A good EHR will allow him to document better and more legibly (unless he is that one rare doctor who actually writes legible words on the chart); will automatically calculate coding levels based on elements that have been performed (such as expanded problem-focused history, Medicare evaluation and management coding rules); which will allow him to optimize his coding by making sure he chooses the correct E/M code for a given visit; will prevent potential adverse reactions for patients who may have a drug or allergy interaction with a prescribed drug; will enable records to be shared quickly and easily with referring physicians or other physicians within the practice; and multiple other benefits I don't have the time to write down. Does the writer know that it is estimated that physicians undercode by 5% to 15% on average? And some practices even more? Why? Because paper charts can't help satisfy the documentation rules set forth for reimbursement. There is no physical way to check off what elements are done, the number of history components, exam, etc. So he has to guess or "try his best"which results in most likely picking a lower code so as to not "overcode" and potentially get audited. So there is his "save money," but it's actually "make money."
The real issue here is that the writer did not do his homework and bought the wrong system for his practice. He spent a quarter million dollars on a system that he may not have rigorously investigated to make sure it worked for him, and he has buyer's remorse. Maybe he did not get enough training. Maybe he did not push the vendor for changes or modifications to make the system work for him.
Instead, he throws out a letter that is read by many physicians and use the words "idiots," "hogwash" and "taking a vacation." Those words should be directed toward him, I think, for not making a better decision. There are many offerings out there for EHRs, and he chose the wrong one. So next time, point the finger inward instead of blaming the entire industry and saying EHRs are "nonsense."
For the record, I am the chief executive officer of an EHR company that set out to do exactly thatbuild a better mousetrap to make things easier, more profitable and more efficient. Our customers love our product, as it does what it is supposed to. There are many EHRs out there that do a great job. He just chose the wrong one. Next time, he should save the hyperbole and re-examine his decisions, or just go back to what he is comfortable withthe pen and paperand enjoy his vacation while he undercodes and loses 5% to 15% of what he could be making.
Ryan LevacyCo-founder/CEOmdTeknixAustin, Texas To submit a letter to YOUR VIEWS, click here. Please include your name, title, company and hometown.
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