by Peter Beck on January 7, 2010
in Blog
With all the money they make it appears that is the least they can do with doctors and hospitals struggling to survive in many areas of the US. There are also many other EHR vendors who are not financed or part of an insurance company that can help as well.
Interesting and disturbing post from The Medical Quack.
If I’m reading this correctly, the Ingenix subdivision of United Healthcare is offering a sweet deal for small group docs to get an EHR system: 6 months, no payments, to sign up for their version of the Allscripts-Misys electronic health record.
But it sounds like it comes with a kind of Big Brother price.
Derm offices using the system that suddenly had non-payment when the “business intelligence arm detected potential fraud.”
The State of Washington using the system to “score” Medicaid claims.
I’m all for the third quoted use: Sutter Hospitals using the system to look at costs, presumably to tighten things up financially (while hopefully looking just as closely at quality). But it’s a bit concerning when some of the first uses of an insurer’s EHR sound more “1984″ than “It’s A Wonderful Life.”
Posted via web from Peter Beck Kim’s Other Blog
by Peter Beck on November 30, 2009
in Blog
It’s not quite the world’s oldest profession.
More like civilization’s.
It predates EHRs, paper, papyrus…even clay.
So long as there has been writing, even on stone tablets, there have been scribes.
Folks trained to commit words to a more durable medium than fallible memory.
Folks who did nothing else besides that special act of translation.
Because the movers and shakers who were actually talking, doing, or thinking the important stuff were busy with the important stuff — and were unable to scribe simultaneously, and too busy to learn.
Sound familiar?
[click to continue…]
You’re halfway home. Part 1 discussed Tests 1-4, for picking physician-friendly EHR features — and avoiding those that would incite a riot.
5. Pare With Care
Eventually, you’ll feel tempted to carve away what seem like excesses — don’t do it! Not without checking at least three times!
Scut step reduction always gets a PASS, if by “scut” you mean “multiple steps that are invariably done in a sequence that can’t go otherwise.”
So if you ALWAYS sign-off a lab value by
- removing it from your lab listing
- tasking a staffer to notify the patient
- instructing the staffer on what new action the patient must take
then it makes sense to carve away 2 of those steps, and to have a single button that does all 3.
If at any point, however, something else might happen — like you’d want to keep a lab value in your listing once in a while, or an office colleague might notify the patient instead of the staffer — then prepare for howls of protest if you take away those other options.
Sometimes those other options might not make sense. The need for them may occur incredibly rarely. But, if you don’t thoroughly investigate these branching pathways before you cut them, I can guarantee that you’ll take out weight-bearing walls for certain practices.
6. Always Customize By Provider, If You Have The Option
This does NOT mean to build a secret garden for each and every doctor; it means, given the option to provide adjustable settings at the enterprise vs. practice vs. provider level, it’s hard to go wrong with the lowest level.
If the system will allow it, let each doctor make and save their own customized lists, plans, macros, etc. Physician variance is legendary; consensus, like the kindness of strangers, is less of a sure bet.
7. If Something Works, Copy It Shamelessly
Life is short, and medical office workflows are complicated.
If there’s a doctor-approved example of something that works and is popular, why ignore that and start from scratch (especially from scratch without clinician input)?
When you hear comments like, “Oh, I always use the XYZ system” from every specialist you talk to, or “When the fur is flying and there’s nobody to help me, especially the comatose patient, I can always rely on ABC to get me out of a tight spot,” those are the X-marks on the tattered map that tell you “Here Be Treasure.”
Physicians can come up with some pretty imaginative and roundabout ways of doing things, but they instantly know a good thing when they see it. A good engineer knows the value of starting from a solid, working model whenever possible. The key is to acknowledge that “solid,” and “working” are concepts best vetted by physicians, when it comes to healthcare IT.
Are there any litmus tests that you’ve found valuable for separating the gold from the lead? Please put it in the Comments section below!
