Looking forward to spending every last day of the remaining calendar year stressing out my staff and wearing out every patient on virtually every encounter left for 2012.... and pulling 12-14 hour days for the mad rush to achieve "Meaningful Use"

Worst thing to happen to health care in my entire career.

And the bums in DC are planning even worse for the next decade.

Like I said.... born 10 f'n years too late.

Merry Christmas?

It wasn't any different 10 years ago.

My old man retired because he said he was done pushing pencils and paper instead of treating patients, and HE wished he was born 10 years earlier.

There's no escaping it, doc.............no matter when you were born.

No change comes without chaos!


Fishy

You should be able to choose how you operate the business you own.

I haven't heard a Doc or health care worker say anything good about this "New Plan"

I just changed to EHR in August and have a Ipad for chart notes. I had a new patient almost leave because he thought I was playing games on it. Once I showed him it was how I take notes he stayed, but I no longer take it in with a new patient. I will most of it like I used to so I can absorb what the patient is telling me and not just punch buttons on the ipad.
Oh yeah, meaningful use is crazy, more hoops to jump through only to make the patient pay more in premiums and to make the allowable less for doctors.

Hell, you know what Pol Pot did for the Mds. And damn near anyone
else with an education.

For those who don't know the EMR (Electronic Medical Record) aka EHR (Electronic Health Record) is way over due for the patient and in the long run will drastically improve the quality of healthcare and reduce costs. Meaningful use sets the standards and provides payments from the govt to providers who follow them. None of this is related to Obamacare. Suck it up Docs. It's way past time to embrace high tech. BTW, lot's of high profile companies are working on new or modifying existing software for EMR and have a bevy of physicians consulting on designing this stuff. Some day a patients full records are going to be portable/visible to all whom the patient allows to see them and a lot of medical errors will be prevented because of the electronic nature.

I believe that many Mds. use the hi tech method of posting data
for their patients.
I know in my case the primary car physician posts my lab work
from the annual physical, on line where I can read it or print it
out if desired. Same for the cardiologiist and urologist.
Lucky me: Had bladder cancer and have a screening every 6 months.
Had a 4 way bypass and that gets me another annual
physical and a stress test. glow in the dark style
However, some of the Mds that serve in rural areas don't pull in
enough cash to absorb some of the time intensive paper requirements. That will probably drive some more of them to
go where the money is.

stlhead,

I am not complaining about using the new technology because it is easier to use and like you said it does benefit patients, but I do not like all the extra hoops and costs.

Meaningful use provides govt payments to alleviate the costs:

Incentive Program for Electronic Health Records: Issued by CMS, these final rules define the minimum requirements that providers must meet through their use of certified EHR technology in order to qualify for the payments for Stages 1 and 2 of meaningful use.

Anyway, you can see I've got an interest/experience in this stuff. When I first delved into Healthcare IT I could not believe how behind the times health care is. Scary/dangerous behind. A persons bank is vastly more high tech/intelligent than their physician, clinic or hospital. And banks make errors all of the time.

Any payment system can be adjusted, usually downward, and very seldom do they go up.

I've had docs with family practices shut down their offices because of how much medicare/medicaid payments were cut. They received premiums in the past because they served a rural area, and now they see those reimbursement rates go down yearly.

People don't like change, so it's no surprise that people don't like Obamacare.

The alternative was to kick the can down the road another 10 years.

Somehow, I don't think that would have been much of a solution either.

The GOP could have tackled this when they had the WH and congress, but they were too busy to do anything about it..................so we got Obamacare instead.

Congratulations?

No, man..............you got it all wrong.

Vote first...........read later.

Why do you think congress' approval rate is so lofty?

You know what else destroys jobs? Health care costs.

This issue should have been tackled in the 80's or 90's.

STFU Runt!

Go kill yourself, Sol Dickless, and do the world a favor.

Is your vagina still sandy from a few days back when you were crying like a little bitch? Sand removal from your twat is probably covered under Obamacare, so you have that going for you.



Hank,

The market is just like people............hates change. My deduction for health care went up for next year, but not by a significant amount. We've been warned that could change depending on how this whole transition takes place - I saw much bigger increases in my health care expense over the last decade or so, prior to Obamacare being passed, so I'm not seeing that much cause-and-effect in my microcosm.

YMMV.

Somehow, I figure we'll survive the change and it won't be as big a disaster as some have predicted. I could be wrong, though, as it's never wise to underestimate the government's ability to f.uck things up.

Sir Dan S,



Respectfully, The market is not "just like people". The "market" is people. And yes people do not like change, because change often brings pain.


The crux of the matter is, how could a government have a positive or a negative influence on a health care system.

While I am sure that many on this board. that is comprised mainly of residents of King County; believe that "Single Payer" is the answer, I am just as sure that our current, and soon to be passing, system has provided the revenue and support for research and development, that has brought many of the miracle cures and advances that we now have in modern medicine.

The system that will be soon be replaced has brought people of means from all of over the world to our country in search the worlds finest medical system.

With incentive to produce being removed, work hard and save, now seems so yesterday.

Point taken.

Spending 80% of my time "documenting" what I'm doing on a GD computer instead of just doing it. Given the chance to fish or cut bait, I'd just as soon go fish!

For guys that actually make a living by "doing" rather than sitting on there sorry a$$e$ typing about what, how, and why it needs to be done.... this is a horribly painful change for the worse.

Not only that, the entire doctor-patient interaction has been severed by interjecting a keyboard and screen between the key players. Patients universally feel like the doc is treating the computer instead of the them. Docs have been reduced to robotic "box checkers", dotting every "I", crossing every "T", clicking every GD box, and running every ridiculous report the govt deems necessary to fulfill its version of "meaningful".

"Meaningful use" needs to be renamed "meaningless excuse" ... to waste taxpayers money and stifle physician productivity.

Tell that to the family of the patient who was just killed because he was given Penicillin when his records clearly state he's critically allergic. Or maybe it wasn't "clear" because it was in some Doc's unreadable handwriting. Or maybe that original incident is sitting in the files of three doctors ago. Any physician who still wants to do pen and paper should be drummed out of the business for good reason. All patients should be demanding better. Errors happen all of the time with most of them swept under the rug.

Anyway, you can see how strongly I feel about this. There are many corps in a race to put out the best software package(s) and grab market share so eventually it will all be streamlined and a lot less people will be f'd up by errors.

stlhead said "Anyway, you can see how strongly I feel about this."

I find your statement interesting, and it supports my belief that while most Liberals tend to feel and react, the majority of conservatives are more likely to think and reason, before coming to a conclusion, and then taking action if any is in fact warranted.

LOL

x Ten Bazillion Gillion.

Fish on...

Todd

"I believe it supports my belief"


Your beliefs support your beliefs? A RWWJ caught in an infinite loop.

+ a few more bazillion

It brings me pleasure to see how easily the Left hand side of the peanut gallery is amused.

It's not easy...but thankfully the RWWJ's around here work at it, and hard.

Fish on...

Todd

And if a googol of giggles were possible the LWWJs provide them.

While mental health goes begging in this country. Why can't we fix it?
It might take profiling. Heaven forbid. Higher taxes too. JFC

Yeah those RWNJ's really thought out 9/11 and the two subsequent wars! Bunch of brainiacs.


Fishy

Not to worry. You will never be put in the position to define a
response to an atrocity like 911 or the follow up in the ME.

The computerized entries are no guarantee mistakes won't be made. Investing in good risk management processes would be much higher yield.

Just because you can read a computerized entry in the EHR doesn't necessarily mean you'll think to look at it, let alone be able to efficiently find and retrieve it. I can draw a picture in seconds depicting all the key pathology that would take 10-20 times as long to describe in a keyboard narrative. Or I could try drawing it on the computer and have it look like a pre-schooler's sketch ala Stam holding a fish... and then spend another 5 minutes labelling it. JFC! What a waste of time!

The computer is just an alternative data storage strategy. A mind boggling SLOW ass process to get the $hit in, and in the best of circumstances possibly just as easy to get the $hit out compared to a paper record. Net workflow is a HUGE negative.

And god forbid when the computer hiccups (yeah like that $hit never happens) or when the power goes out. A lot of good that computer is gonna do you. My pen works just fine without electricity.

It is a great strategy to gather collective data on billing and utilization of services, and third party payors LOVE it for that reason. That's the true benefit to the industry.... it's a great "big brother" tool.

I know some think of it as a pain in the ass but there are others, Doctors and Nurses, who have switched from practicing to IT consulting because they truly feel they can help many more patients in the long run by getting us out of pen and paper mode.

Our generation will probably never have everything on the EMR because there is too much data floating around in files. But the younger generations will fully benefit from it. And it will reduce malpractice. Of course procedures would need to followed, like checking the computer, just as they need to be followed today.

In my example with your allergies listed on the EMR eventually all systems will be required to read that. If the doc, pharmacy, whomever enters a prescription that contains a drug, ingredient, etc that the patient is allergic to it will produce a big warning. The conflict checking that goes on behind the scene against the FDB is very complicated. How do I know? The code I wrote is being used right now in places like the Mayo clinic.

A lot of docs are now doing their rounds using hand helds like IPADS and in the future I bet even an EMT will have a hand held device linked to the EMR. For the unconscious maybe it will scan finger print or retina. An unconscious patient having a heart attack the EMT selects Epinephrine the screen might show "CRITICAL ALLERGY TO EPINEPHRINE!!!". Just saved a life. Or the scan may show what chronic condition or disease the patient suffers from. And of course it would show all of the prescribed meds the patient is taking. Way too many positives out way the negatives.

And all computer systems these days have redundencies built in for power outages or disaster recovery especially hospitals.

I remember when people complained about having to scan bar codes. In the medical world bar codes are not only time saving but life saving now.

The EMR will also be used to track diseases and such by population which won't be patient specific. Something like "Why is there a higher rate of Thyroid cancer in Seattle than other cities?" Or it can be used to track Mental and behavioural disorders by population and maybe solve our mass murderer problems.

"Just a minute.....I have to log in"
"Your name again?"
"SS number?"
"Sir? Sir? Sir, are you OK?"

Half way thru 2013.....

and it still f'n sucks!

JFC! Productivity stifled by 25-30% minimum.

Quality of care a definite minus.

Liability to both Dr and patient a quantum leap greater... esp for us decisive "gitter dun" docs.

The ones that enjoy sitting on their asses futzing and mulling over their diagnostic/treatment options, contemplating what to do next will probably do just fine. They still won't get zhit done.

Fish or cut bait....

I'd rather be fishing.

ACA is a joke.