Doctors look into the digital age
HITECH Act entices physicians into future with incentives
By Jill Coley
The federal government has put aside nearly $20 billion to convince doctors to ditch their manila files for electronic medical records. But look at any physician's walls of patient records, and the enormousness of that task becomes apparent.
The Post and Courier
The shelves of patient files are overflowing at Newton Family Practice in West Ashley.
In the Lowcountry, opinions are mixed. Most agree the move would reduce unnecessary testing, administrative overhead and medical errors. Yet with so many systems to choose from, patient privacy concerns and the time it takes to learn new software, money might not be enough.
Dr. Christos Maltezos, a Mount Pleasant endodontist, is ahead of the curve and already paperless. "That's where the future is going," he said. Patients can fill out forms at home and enter their medical and pain histories online.
In addition to streamlining administrative work, going digital also reduces forgery since doctors can send prescriptions to pharmacies digitally, said Maltezos, who can access patients' records on his BlackBerry no matter where he is. "I don't think I could do it any other way now," he said.
Starting out digital is easier than changing over. The older internist may imagine scanning in 300-page medical records. But after a few patient visits, most of the information would be contained in an electronic file.
The Health Information Technology for Economic and Clinical Health Act, or HITECH,
became federal law in February and created payment incentives in Medicare and Medicaid to encourage providers to go digital. It wasn't long before electronic medical record vendors began using the promise of stimulus money to entice physicians.
Chris Hughes, founder of Advanced TeleHealth in Mount Pleasant, consults physicians before they adopt an electronic medical records system to make sure their practice is ready for the technological leap and is compliant with the Health Insurance Portability and Accountability Act, or HIPAA.
The economics of the situation is going to drive electronic medical records forward, Hughes said.
Dr. Dave Albenberg is passionate about electronic medical records but worries the government's lofty goal may not be feasible.
Albenberg invested about $150,000 in a digital system for his concierge practice, Access Healthcare, in Charleston and Mount Pleasant.
Every doctor thinks it needs to be done differently, and getting all of them on the same platform is impossible, Albenberg said. "This is something you can't throw money at," he said.
Dave Terry, former administrator of James Island Medical Care, knows firsthand the pitfalls of electronic medical records. The 6,000-patient practice tried to go electronic about six years ago, and although hardware and software has improved since, the experience is still fresh in his mind.
Doctors use so many categories of codes, Terry said, that when physicians got in a room with a patient, the program went "six ways to Sunday."
"You feel quite often like a deer in headlights in the middle of a patient encounter," he said. Training was a problem because doctors couldn't stop seeing patients long enough to learn the system. And if a staff member was sick or on vacation, their replacement had to be schooled in the software.
"We yanked it out and went back to paper," Terry said.
Reach Jill Coley at 937-5719 or jcoley@postandcourier.com.
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Comments
TEACHER311 (anonymous) says...
Enormity, Jill, enormity is a real word. "Enormousness" is not. Please ask someone to let you borrow a book called a The-so-rus or one called a Dick-shun-air-e to help you as you continue your writing career for the media. I encourage my middle school students to learn new words, but caution them about making up words that sound kind of like a real word.
May 4, 2009 at 6:06 a.m. ( permalink | suggest removal )
oldglory (anonymous) says...
Teacher, nicely put! It's always great to be enlightened and/or refreshed!
I'm over 70, and I still recall my English teacher. At reunions I always told
her how fortunate I felt to have had her expertise.
May 4, 2009 at 7:54 a.m. ( permalink | suggest removal )
tc2 (anonymous) says...
I had the exact same thoughts as "y'all". But, I used the google lookup definition and it came back with the definition you would expect!?
May 4, 2009 at 8:07 a.m. ( permalink | suggest removal )
jk_newhard (anonymous) says...
While I applaud the sentiment, Teacher's comment would probably have better impact in a respectful private email. The writer might have learned something. If she even sees these comments, she is most likely focusing on the rude sentence about the thesaurus/dictionary.
Just as proper grammar should never go out of style, neither should common courtesy.
May 4, 2009 at 8:22 a.m. ( permalink | suggest removal )
iceman1978 (anonymous) says...
We've got a similar problem where I work. The attic is filled with bookshelves, filing cabinets and boxes; all of which contain records from our service and sales departments. To switch over all you would need is a 1 TB hard drive, maybe a 2 TB drive depending on how much data. It's making the changeover that's so time consuming.
May 4, 2009 at 10:22 a.m. ( permalink | suggest removal )
UrGatorbait (anonymous) says...
touche newhard.
All that typing and converting of the records should keep a few folks employed and maybe save a few trees.
May 4, 2009 at 10:24 a.m. ( permalink | suggest removal )
3olivesmike (anonymous) says...
Teacher
What do you tell your students about being a sarcastic, pedantic know-it-all and the effect it has on cumulative civility.
May 4, 2009 at 11:02 a.m. ( permalink | suggest removal )
eyfigueroa (anonymous) says...
Touche indeed 3olives & newhard.
May 4, 2009 at 11:26 a.m. ( permalink | suggest removal )
youngatheart (anonymous) says...
My doctor's office is paperless and it's great. No more flipping through papers to find the results of blood tests etc..... It's all there on the computer.
May 4, 2009 at 12:06 p.m. ( permalink | suggest removal )
JustJennings (anonymous) says...
We should all be concerned about privacy issues with this.
May 4, 2009 at 12:50 p.m. ( permalink | suggest removal )
JustJennings (anonymous) says...
It is just too easy to hit the forward button on a computer. As technical advances are made, laws need to keep up and violation of medical confidentiality should be made a felony. Like many government rules, it is still a joke right now.
May 4, 2009 at 1:04 p.m. ( permalink | suggest removal )
olloh (anonymous) says...
Teacher311,
Better to remain silent and be thought a fool than to speak out and remove all doubt.
I encourage you to follow your own advice. To save you the trouble I refer you to the following from The American Heritage® Book of English Usage A Practical and Authoritative Guide to Contemporary English:
3. Word Choice: New Uses, Common Confusion, and Constraints
§ 111. enormity / enormousness
Enormity is frequently used to refer simply to the property of being great in size or extent, but many people would prefer that enormousness (or a synonym such as immensity) be used for this general sense and that enormity be limited to situations that demand a negative moral judgment, as in Not until the war ended and journalists were able to enter Cambodia did the world really become aware of the enormity of Pol Pot's oppression. Fifty-nine percent of the Usage Panel rejects the use of enormity as a synonym for immensity in the sentence At that point the engineers sat down to design an entirely new viaduct, apparently undaunted by the enormity of their task. Even if you side with the dissenting 41 percent and allow for enormity's largeness, you may want to avoid it in phrases like the enormity of the President's election victory and the enormity of her inheritance, where enormity's sense of monstrousness may leave your audience laughing when you don't want the laughs.
May 4, 2009 at 1:24 p.m. ( permalink | suggest removal )
abitskeptical (anonymous) says...
I'm curious as to why, with the economy such as it is, the federal government would be motivated to spend $20 billion to "convince" doctors to switch to electronic files.
What justification do they have for wanting to spend money on this?
May 4, 2009 at 2:48 p.m. ( permalink | suggest removal )
wjhamilton3 (anonymous) says...
We've been moving towards electronic records in the court system for a decade. It makes a huge difference. The judge can pull up a file and the prosecutor and the lawyer, all at the same time from different places. It takes a long time to make the transition.
May 4, 2009 at 3:30 p.m. ( permalink | suggest removal )
abitskeptical (anonymous) says...
But in the court system,as opposed to medical records, much of the information on those electronic files is part of the public record.
As convenient as electronic file & record keeping is, nothing beats the original hand written & signed notes/orders/Rx's as an official record.
May 4, 2009 at 4:53 p.m. ( permalink | suggest removal )
Numba10 (anonymous) says...
at VA hospitals doctors type thier entire record of your visit into the computor as they check out your condition---also no prescriptions as it is sent by computor to the pharmacy---they even have robots to deleiver your meals to your floor----
May 4, 2009 at 5:27 p.m. ( permalink | suggest removal )
dbammann (anonymous) says...
I work at a practice in Greenville, SC which has had electronic medical records since 2006. The reason EMRs fail is lack of training, lack of support from the your IT company and templates not corresponding with the specific practice. I suggest if you do not have EMR look into different systems, do not settle for the cheapest.
- Why are most of the responses about english? This should be about EMR and by the way look for one with spell check.
May 5, 2009 at 10:16 a.m. ( permalink | suggest removal )
olloh (anonymous) says...
dbammann,
I agree with your statments. All of the popular EMR have their pros and cons. My job is to collect data from various practices throughout the state. Some EMRs are a breeze to export data from, some others I'd rather get my teeth pulled with no anesthetic.
May 5, 2009 at 11:51 a.m. ( permalink | suggest removal )
dbammann (anonymous) says...
to olloh
I highly recommend you look at NextGen. It is the system we use and enjoy with having TSI Healthcare for the intial set up and support. Enjoy! And do not forget - to say, Happy Nurse's Day to your support team!
May 6, 2009 at 8:36 a.m. ( permalink | suggest removal )
21stCenturyRox (anonymous) says...
I think this is great - while there are certainly privacy concerns, they're not unmanageable. And paper records certainly have their own security issues! I've been using Microsoft HealthVault ( http://www.healthvault.com/Personal/i... ) for a while, and since I gave my doctor permission to share info with me, it's been a much more positive experience for both of us.
May 7, 2009 at 4:34 p.m. ( permalink | suggest removal )
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