I do have a friend who is developing the kind of EHR you are talking about, a doctor driven system. However, with the medical field consolidating so much, being driven by the insurance companies, it will probably be difficult to sell such a system.
These are excellent observations. Computers have taken away all the fun out of being a doctor. Patients are all different, which is something that computers cannot understand. Currently, doctors must follow standard protocol for a patient based on what the computer tells him; or prove to the insurance company that a different protocol is necessary. This takes time and is often difficult. If they do not prove a variance in protocol is necessary, the doctor will not get paid, or could be fined. This is not a good system for either the doctor or the patient. The power to diagnose and the care that must be given to a patient needs to be taken back from the computers and put back in the hands of the doctors and patients.
Glad to see a real look. The EHR has been designed for others. In order to develop a better system, voice must dominate design and use but various text tools can add to that. As you note software developers must integrate with the primary user, behind the scenes automation can extract for others. Spiral development should be the approach, We can see EPIC is more than tedious for both practitioners and users.
No experience with diagnostic aid tools, but it is true that knowledge grows exponentially so that keeping up is quite hard for busy practitioners. As before such tools need to embed designers with users.
As a long-time devotee of substantive documentation in the medical record, written and electronic, I am interested in Matt's perspective on the single greatest failing of the EHR in today's modern medicine - the copy and paste sloth. Until insurers agree to omit payment for progress notes that include >90% copy and paste from previous note, the immense vacuity of today's medical record will persist. We are doing our learners a terrible disservice by accepting the current state of practice.
In my experience, Matt, the younger and more junior the physician, the more use of duplication is likely. Our trainees are not being taught the art of documenting important new clinical information in the daily progress note. It would be of interest to see what insurers are contemplating when they are looking at reducing costs. Being of the "old school", I find the unthinking copy and paste approach to be a lamentable means of accommodation and not a practice that enhances medical care. I do not have the imagination to know what kind of solution to propose.
Thank You, Matt.
I do have a friend who is developing the kind of EHR you are talking about, a doctor driven system. However, with the medical field consolidating so much, being driven by the insurance companies, it will probably be difficult to sell such a system.
These are excellent observations. Computers have taken away all the fun out of being a doctor. Patients are all different, which is something that computers cannot understand. Currently, doctors must follow standard protocol for a patient based on what the computer tells him; or prove to the insurance company that a different protocol is necessary. This takes time and is often difficult. If they do not prove a variance in protocol is necessary, the doctor will not get paid, or could be fined. This is not a good system for either the doctor or the patient. The power to diagnose and the care that must be given to a patient needs to be taken back from the computers and put back in the hands of the doctors and patients.
Glad to see a real look. The EHR has been designed for others. In order to develop a better system, voice must dominate design and use but various text tools can add to that. As you note software developers must integrate with the primary user, behind the scenes automation can extract for others. Spiral development should be the approach, We can see EPIC is more than tedious for both practitioners and users.
No experience with diagnostic aid tools, but it is true that knowledge grows exponentially so that keeping up is quite hard for busy practitioners. As before such tools need to embed designers with users.
As a long-time devotee of substantive documentation in the medical record, written and electronic, I am interested in Matt's perspective on the single greatest failing of the EHR in today's modern medicine - the copy and paste sloth. Until insurers agree to omit payment for progress notes that include >90% copy and paste from previous note, the immense vacuity of today's medical record will persist. We are doing our learners a terrible disservice by accepting the current state of practice.
agreed - https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2796664
In my experience, Matt, the younger and more junior the physician, the more use of duplication is likely. Our trainees are not being taught the art of documenting important new clinical information in the daily progress note. It would be of interest to see what insurers are contemplating when they are looking at reducing costs. Being of the "old school", I find the unthinking copy and paste approach to be a lamentable means of accommodation and not a practice that enhances medical care. I do not have the imagination to know what kind of solution to propose.