EMR: Stop the Train.

June 26, 2010

In our experience, EMRs are not working, and we need a different solution. Fast. Here are just three of the problems. In our opinion, Medicare needs to stop the train at the station until some other important issues are addressed that enable EMR to be effective.

In our experience, EMRs are not working, and we need a different solution. Fast. Here are just three of the problems. In our opinion, Medicare needs to stop the train at the station until some other important issues are addressed that enable EMR to be effective.

1) The current EMR systems are designed for the doctors to enter the data. Who has time to do this and take care of their patients? Something suffers, and unfortunately, it’s the patient care. Many physicians we have worked with who began using EMR and stopped dictating are now back to dictating their notes. Pointing and clicking just takes too much of their time. And, patients often complain that their physician is examining the computer during their appointment – instead of them.

2) The AMA and the specialty societies need to redefine the E&M codes before EMR can work – otherwise the note has no meaning. There are no choices in EMR for moderate to high complexity visits so the note’s value is subjective, and the reader has to make a subjective decision regarding the value of the cognitive effort, what’s ailing the patient and what the plan should be. This issue has also triggered unnecessary physician audits.

3) The learning curve on these EMR systems is significant. Most physicians and staff are at ground zero with no training or education. They’re still trying to learn how to do electronic prescriptions that Medicare dictates. It’s just another Medicare requirement that will not produce the results they are seeking until the “back room” problems are fixed.

Stop the train. Fix the coding “engine”. Then we can talk about full-steam ahead with EMR.