From the American Medical Association comes a recent story on EMRs and the paperless medical office. I think it touches quite effectively on the issue facing medical offices today – transitioning new patients to the new EMR has proved a lot easier than turning older paper records electronic. In one of my earlier posts, I’d written about this topic. This article provides some clever strategies in identifying which paper records to convert earlier than others.
Among the points discussed:
– EMR use does not equal paperless: And yet, these two ideas somehow seem conflated in people’s minds. A doctor I spoke to recently said he had assumed that the EMR vendor would convert older paper records to electronic as part of the EMR purchase package. Well, the vendor might – for a fee. Electronic conversion ranges from simple paper scans to character/word recognition. For truly rich use of your data, say for report generation purposes, you’ll want something that populates a database. In fact, “data transfer probably is going to be a significant line item in the EMR budget.”
– Not all data is equal: Having an EMR doesn’t mean that every little scrap of paper from the patient’s records needs to go into it. Doctors can make the call on the kind of data that they find most useful. It would however need some amount of planning and insight, not to mention time, to make this happen. What’s important depends on specialty as well.
– Not all patients are equal: If a small proportion of patients you see tend to be the ones that come for repeat consults, it might make more sense to get the entirety of their paper records into the EMR.
– Don’t make a beeline for the shredder immediately: Really, this should be self-intuitive. Unless you’re sure that every important piece of information you need has been transferred to the EMR, and the EMR data matches what’s on paper, don’t shred the patient’s records.
The only real quibble I have with the article was where it mentions that one company found that “having the doctors enter the data ensured the integrity of the information and helped them learn the new system.” Seriously? Have your $200+ per hour physician enter older records into an EMR, when you can get a temp or third-party vendor to do it for a fraction of the cost?
The statistics at the end of the article are quite interesting. The first statistic is especially encouraging.
A survey of 200 health IT professionals found that hospitals are taking varied approaches to digitizing their records. (Respondents could give more than one answer.)
49% have scanned what they need and stayed within their budget.
23% are within budget but still have a backlog of records to scan.
54% are scanning records onsite.
29% are using a centralized scanning location.
72% are relying on full-time employees to scan.
9% are using third parties.
6% are using part-time staff.
44% are not explicitly measuring the effectiveness or productivity of their scanning process.
58% plan to shred paper records once scanning is complete.
38% plan to store paper files in onsite records rooms or offsite storage facilities.Source: Survey by information management company Iron Mountain, July
Nice. So, the AMA really does want their doctors to become data entry clerks. Sounds like a great way to alienate the doctors who already are reticent to implement an EMR, make them do data entry of the old charts into the EMR.
Out of not wanting to be a data entry clerk, I ditched the meaningful use fiasco.
Dr. West, could you elaborate? Does your office not have an EMR in place now? Or are you using it, but for MU reporting?
John, technically, it wasn’t AMA recommending that doctors act as typists. But rather, the article noted that one company had done so, and that it was beneficial, without any sense of irony. While I agree that using a system hands on gives one an understanding of the product, I really think doctors’ skills are better put to use.
ugh.. we need an edit button. I meant – are you using an EMR but not for MU purposes?
Priya,
Not to speak for Dr. West, but he has an EHR, but just has chosen not to show MU as you guessed. In fact, I believe he’s cut his Medicare completely. Turns out, Dr. West is also your neighbor.
I agree the doctors skills are better put to use in other ways than inputting old records. Either way, the AMA seems to have lost being the voice of the physician.
P.S. There is an edit button for you as long as you were logged in to comment. Just click the little “^” that’s after the date of the comment. That will let you edit your comment.
Priya, it’s exactly as John mentioned. I really enjoy my EMR system but don’t use it for MU reporting. I also would agree with John that the AMA is not really the voice of the physician in modern medicine.
Paper charts to EMR/EHR is the transition journey. Yes, there will be some bumps to overcome as other industries had couple decade
back. I can read EMR as “Eternal Medical Record” and “Evolving Medical Record”, which says itself.