Francine Hardaway
On Electronic Health Records
In Doctors' Offices

From: "iisx2002"
Date: Tue, 15 May 2007 15:23:18 -0000
Subject: [stealthmode] What to do if your health records are not electronic

After years of bitching in this space about how much I wanted my health record to be electronic and accessible to me, and to all my doctors, so I could stop filling out forms six times over, some friends of mine and I finally decided to do something about it.

All doctors know they are going to have to go to electronic health records. Right now, in all but 10% of doctors' offices, when you arrive they have to find your chart, pull it, and put it in a plastic folder at the door to the examining room they stick you in to wait. The frantic doctor will glance at it quickly as he walks into the room. Perhaps the nurse or a medical assistant will have taken the vitals and entered them. Perhaps your latest lab tests are in the chart, which can be a thick folder, and perhaps they are not. The doctor is trying to see forty patients a day to cover his overhead, most of which is related to paperwork.

You know the drill. As a consumer, you pray for an electronic health record, for both you and the physician(s) you visit. But the doctors, who now have acres of paper records, are terrified to automate their practices. What if they inadvertantly violate HIPAA? What if the network goes down? How can we afford the expense? How do we know what to buy? What if we don't type? How do we get the records into the EHR from the paper charts? Won't this make me slower and less productive, at least in the beginning?

These are all good and valid questions. I remember them from when billing and claims processing software first came out. But the government, the largest healthcare payer in the country, is going to mandate EHRs pretty soon, just the way it mandated claims processing. One day you could no longer submit claims to Medicare unless you did it electronically, and everyone out and bought software, engaged a clearing house, bit the bullet.

The move to paying providers on the basis of outcomes is just around the corner, and it's a prime reason why doctors MUST automate. They will need to access a lot of data to prove they are doing a good job, not just for Medicare, but for every other insurer. This will come fast now, because the technology is really there, and the world knows it.

Byron Davies, a brilliant guy from MIT who is now in medical informatics, and Roy Frieband, DO, a physician who wrote his own EHR, uses one, and knows how docs feel, and I have created a not-for-profit called the Arizona Health Information Technology Accelerator. We have trained ourselves in all the major products, and developed a process to help each different practice evaluate what's best for it. We represent nobody. In fact, we know what's wrong with EVERY product.

We are now at the point where we can go into a practice on a consulting contract, help them choose the "right" (or the least wrong) product, and help them implement it -- deal with the change management and work flow issues. We are totally up front about how difficult it will be, but we can shortcut a lot of the time-consuming up front work. We can also make it a bit easier to get up and running on EHRs. And because we are a not-for-profit, we don't have to charge the kind of fees the big firms charge.

It's a tough transition, but I remember when Intel went to SAP ten years ago and that was a tough transition, too. Now it's a product they love. Or at least one they need to have in order to remain competitive. Not to mention that Intel originally had a choice about whether to automate its enterprise resource planning, and the doctors won't have that choice. They are too far behind the technology curve.

So ask your doctor if AHITA is right for him. :-)