It is past time to acknowledge the real costs and challenges of electronic documentation and the financial and physical toll our government has placed on medical facilities and a demoralized healthcare workforce.
The exchange of electronic information across healthcare provider organizations is impeded by technological, clinical-user and patient-user shortfalls. Interoperability between the hundreds of EHR vendor programs is nonexistent, but will eventually find correction as large companies buy out small ones, leaving a new burden of obsolete software for those who complied.
Realistically reworking the onerous, inhumane mandates concerning e-prescribing, EHR and ICD-10 while taking into consideration what actually goes on when trying to care for patients is the only way to move forward with government objectives. Allow doctors to treat patients in accordance with best scientific information, instead of spending their time attempting to comply with nonsensical mandates sold by insurance companies and the IT industry to politicians and bureaucrats for a quick fix of a system with complicated problems.
The tipping point is coming with ICD-10. Can we learn nothing from the wasteland of medical delivery in countries that experienced productivity losses exceeding 40% when they tried it? It is big data with all its sinister implications. It is more patient-care dollars to third parties and IT purveyors. It is delay and deny on steroids! Even the ICD-10 Implementation Guide, published by the CMS, references “failing revenue, delays, denials and rejections” 17 times; and “costs and budget limitations” nine times, with their advice: “increase lines of credit.” ICD-10 increases the number of codes from 15,000 to 150,000. There will be more than 1,800 possible codes for a fractured radius. Why? Centuries of well-established, useful medical terminology is thrown out the window when amputations must be designated “detachment,” or tonsillectomy becomes “resections of the tonsil,” etc. It is not science; it is not patient care. It is hours of searching for correct sequences of up to seven separate codes to identify a 1st-degree burn.
Our healthcare system is at a crossroads of technology and patient needs while the workforce is being pushed off the cliff. This is not science or rationality.
Cathy M. Poole
Medical practice managerHigh Point, N.C.