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I love social media

Posted on July 11, 2011 I Written By

Dr. West is an endocrinologist in private practice in Washington, DC. He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC in 2009. He can be contacted at doctorwestindc@gmail.com.

Shefali Kulkarni recently blogged over at NPR an interesting post “NPR To Friend Or Not: The Facebook Challenge For Doctors.”   It turns out that a majority of doctors, residents and medical students around the U.S. found it “ethically unacceptable to visit the profiles of patients” or interact with patients on social networks for either social or professional reasons.  These findings were recently published in the Journal of General Internal Medicine.  Note was made of the overwhelming pessimistic attitude of those who responded to a survey.

However, I would prefer to be on the optimistic side of history.  Social networking sites are as hot as ever, and I don’t see them going away anytime soon.  People crave social interactions with their friends and, as it seems from my own clinic’s Facebook site, they are not shying away from such interactions with their doctors.  In fact, they genuinely seem to enjoy it.

Most of the concerns on the part of doctors seem to center around HIPAA privacy laws, which I can understand.  However, the AMA’s position statement on social networking seems sufficiently nonspecific and flexible to allow a liberal interpretation of the rules here.  They basically encourage doctors to make wise choices, and I would echo this sentiment.  I’d like to clarify that I’m not telling anyone to go violate HIPAA — just saying that I think you can interact socially online without violating HIPAA.  Patients are free to make statements and ask questions, just like anyone else.  I think doctors should be able to answer questions comfortably themselves in a manner that still maintains their professionalism and privacy.

Now to be honest, it’s clear from some patient statements and questions on my Facebook site that some don’t seem to care much about privacy.  It’s then up to the trained clinician to decide on a case by case basis – big potatoes or small potatoes?  After umpteen years of medical, ethical and scientific training, I think I’ve earned the right to make that decision.

Dr. West is an endocrinologist in private practice in Washington, DC.  He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC, as a solo practice in 2009.  He can be reached at doctorwestindc@gmail.com.

Are most doctors really incapable of successful EHR use?

Posted on June 6, 2011 I Written By

Dr. West is an endocrinologist in private practice in Washington, DC. He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC in 2009. He can be contacted at doctorwestindc@gmail.com.

Over the weekend, I read an interesting article on PhysiciansPractice.com that basically said most doctors are not capable of being successful with adopting EHR systems.  It was such a defeatist attitude that I just had to comment on it here.  I mean, come on.  We’re dealing with professionals who grew up at the top of their classes in school, merited entry into a highly-selective, Mensa-level institution called medical school, and then survived all the hurdles through residency and possibly a subspecialty fellowship.  Hollywood worships doctors and spins out TV shows and movies about these alleged smartest members of our society.  And we’re supposed to buy that an EMR system is just too hard to adopt?  Just because it’s a computer system, I suppose?

While I do agree that we should study why most physicians have not adopted an EHR system in their practices, I think there are many more logical reasons for the so-called “failure” to adopt.  To me, it seems less likely to be a true failure and more likely an active decision (or refusal).  I also think that there are obvious considerations with the potential to contribute to this decision.

1.  Paper is easier to master than EHR systems.  Doctors can scribble a few, quick notes and not worry about format, about as complex as  using a Post-It sticky note.  In 99.9% of patient visits, the notes never see the light of day by an auditor or insurance company.  No one ever really asks to see them.  The payments are just rendered by the insurance company automatically when an electronic claim is sent in.

2.  Paper is cheaper and takes no investment of time or training and very little immediate investment of money.  A patient chart the thickness of a ream of paper basically costs about $4, plus pen ink, and doctors get a ton of free pens from various vendors of just about everything.

3.  Incentive programs only work right now if you see a significant number of Medicare or Medicaid patients, and not all doctors do.  I was only seeing 6% of my patient population as Medicare in 2010.

4.  The hoops established by CMS will only get more intrusive and obtrusive in the future, and most doctors know this due to simply reading newspapers and newsletters.

5.  The potential penalties for non-adopters are around 1.5-2% of Medicare/Medicaid-only income.  A lot in absolute terms, but not so when relatively speaking.

So my final thought is that, while I love my EMR system, I’m not doing it for money or necessity.  I’m doing it because along with the right EMR system comes other efficiencies, environmental friendliness, and hopefully a better quality of patient care.  Oh, and back to my original point, yes, I actually think that pretty much all doctors are perfectly capable of adopting an EMR system.

 

Dr. West is an endocrinologist in private practice in Washington, DC. He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC, as a solo practice in 2009.  He can be reached at doctorwestindc@gmail.com.

AMA’s Health IT Portal: Will Doctors Bite?

Posted on May 27, 2011 I Written By

Katherine Rourke is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Last month, the AMA announced that it was launching a health IT portal for doctors.  The AMAGINE platform includes a fairly robust range of products, including three EMRs, and its price range seems pretty reasonable. Still, I’m somewhat skeptical it will be popular. Lest I be accused of being arbitrary, let me explain.

On the surface, the idea or and product line sound great. In addition to the EMRs, the lineup includes e-prescribing, claims management and clinical support systems as well as reference tools. Vendors involved include Allscripts, CareTracker, Quest Care360, NextGen and DocSite.

Subscriptions to the surface range from $20 per month for e-prescribing to $300 per month for the EMR options, numbers that aren’t likely to send most practices into shock.

Not only that, the AMA seems to have preliminary evidence that this approach works. The trade group pilot-tested the AMAGINE on Michigan doctors for about two years prior to going national, and has to assume that the physician association would have pulled the plug if the pilot went badly.

All that being said, I’m still pretty skeptical that the approach will work, for reasons including the following:

* Despite its being the best-known and largest physician group in the U.S., the AMA doesn’t have a great reputation with up-and-coming young physicians who are first to adopt health IT

* It may sound counterintuitive, but I don’t think doctors want the AMA or anyone else to narrow down their EMR choices. Given the stakes involved, my sense is that physicians want to do a lot of exploring before they commit their lives and workflow to a new system.

* While a best-of-breed portal approach may actually be a good idea, I have a gut feeling that it might actually overwhelm or confuse some physicians. (If it were me, I’d be thinking “One decision at a time please!”)

* Say what you like about vendor technical support, but I bet any decent player would offer better technical support, education and training than an AMA venture.

So, what do you think? Am I off base here, or is AMAGINE going to face an uphill battle?