Ryan Levacy's comments are interesting, and illustrate the problem that salesmen of electronic health-record systems havethey aren't doctors, and damn sure not busy doctors. Did he not see that this "Stone Age" doctor has had not one but two EHR systems in the past nine years? How stuck in the past can I be? When I said these systems don't save time, money, or paper, I speak from experience. Likewise, I say whomever thinks these systems will save money is nuts.
Levacy makes a ridiculous assumption that I would rather use paper charts. He also uses the same old argument about undercoding, and that adding on 5% to 15% is somehow special. It won't pay for the system and in fact leads to what I call sloppy patient care.
As a peer reviewer for the state medical board, I see records from physicians being investigated for any number of complaints. Those that get hung out to dry use templates that all say the same thing every visit, not illustrating any critical-thought process nor any sense of concern for the patient's condition. It's funny to receive the doctor's letter of explanation as to what was done in a given case, carefully stating what the patient said on a given visit, that the patient was noncompliant, missed appointments, took off his or her own cast, etc., and nowhere in the doctor's elegant EHR is any of this documented.
These systems leave a lot to be desired. For Levacy to smugly opine I bought the wrong system is a bit disingenuous as well. Fourteen months ago we did a four-month head-to-head comparison of two systems and were seriously misled about what our eventual choice would do or be able to do. The training we received was woefully inadequate, especially for $250,000. Doctors talk to one another and if one of us hears something good or bad about an issue, we file it away in our memory. Doesn't he think that we as physicians want to provide the highest level of care, save time doing it and get fairly reimbursed? Well, apply that to EHR systems. Every doctor would run out and get one like it was an iPhone if they were that damn great. They are not. Not now anyway, and if his company develops a system that allows me to see 10 to 12 new patients as well as 45 follow-ups in a day and not have to spend more time doing that instead of less, I'll gladly pay him. Doctors who see 20 to 30 patients in a day are not busy, and don't need his level of technology to be accurate or efficient.
As a final comment, our politicians who talk about EHRs saving money get this information from somebody, but not from physicians who work in the trenches. No different from the daily grind an average citizen goes through working in his factory trying to pay his bills and save for retirement. There is a huge disconnect in all of this, and if Levacy thinks I trust a politician to mandate to me how I should practice, document, etc., he is mistaken.
Mark Scioli, M.D.
Center for Orthopedic SurgeryLubbock, TexasTo submit a letter to YOUR VIEWS, click here. Please include your name, title, company and hometown.
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