Today is the third day of the annual APC Board of Regents retreat. We discussed internal medicine issues from many directions. One issue that we must address is the degradation of notes, the degradation of the EHR and the laws that make it so.
One of our key staff, Michael Barr, MD, FACP, has these 3 blog posts that I think frame the issue nicely:
Control+C, Control+V — Out of Control?
Where Is the $81 Billion?
What's in Your Stage 3?
Talking with a colleague who has used AllScripts for 15 years (since it started), he confessed that the latest upgrade slowed down physicians so much that they now fill out a quick paper record and hire "scribes" to enter the data into the EHR.
EHRs would be much better if they did not add requirements. EHRs would be much better if our billing documentation requirements did not encourage copy and paste. We need shorter notes not pages of notes.
I still think the concept is a good one. I know that the current products are not. I know that patient care is suffering.
Congress is practicing medicine. The White House is practicing medicine. They are requiring activities that impair patient care. They would never allow us to do a procedure or use a medication without proper testing. Yet their combined documentation requirements (for billing and meaningful use--a rather ironic oxymoron--are installed with any testing. And their evaluations are almost as popular as Congress.
db is the nickname for Robert M. Centor, MD, FACP. db stands both for Dr. Bob and da boss. He is an academic general internist at the University of Alabama School of Medicine, and is the Associate Dean for the Huntsville Regional Medical Campus of UASOM. He also serves as a frequent ward attending at the Birmingham VA Hospital. This post originally appeared at his blog, db's Medical Rants.