Electronic Medical Records

The largest provider of medical records Practice Fusion has debut its iPad app. The service, which is free for physicians and patients, has grown to be the juggernaut in the electronic medical record space hosting three times as many records as healthcare giant Kaiser Permanente or the VA. Practice Fusion makes its money by being a marketplace for pharmaceutical, device manufacturers and labs. Companies pay for advertising on the Practice Fusion platform to get their products in front of a customer base which $40 billion per year.

At its core, though, Practice Fusion’s goal would be to make permanent medical record access instant and efficient. For this reason it first showed an iPad application for doctors on the run, created by Cooper, the firm headed by Alan Cooper, the father of Visual Basic. It safely provides use of records therefore if a physician will get an after-hrs call in regards to a patient, they’ve almost all their necessary medical data at hands to allow them to make informed choices.

Showing priority for usability, doctors can easily see their day’s visits and instantly dive into each patient’s chief complaint, allergic reactions, problems, medicines, genealogy, hospitalizations, and much more. Doctors can record patient dictations of the signs and symptoms, and mix their very own assessment and plan for treatment with pre-defined treatment plans for common conditions to reduce typing. They are able to also view lists of tasks, and receive push notices of updates using their office.

I like what Practice Fusion is doing in the EMR space and hope they can use their considerable resources to keep innovating and raising the quality of healthcare to the next level.

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Los Angeles Times, April 11, 2011

I am encouraged by the number of articles about emrs that I have seen lately. Most people won’t grasp the benefits of electronic records until they have a head slapping moment like Ms. Gomez had in the story quoted below:

Jennifer Gomez sat at her doctor’s office in Evanston after her appointment, waiting for a handwritten prescription. Minutes later, her doctor wondered why Gomez was still in the office.

What the 20-year-old Loyola University Chicago student didn’t know was that not only had the prescription been sent to the pharmacy, it also was ready to be filled.

"The prescription was at my pharmacy before I even walked out of the office, because everything is computerized," Gomez said of her experience at a clinic run by NorthShore University HealthSystem. "I was surprised, expecting to wait."

Gomez is among the first patients to experience the benefits of electronic medical records, as the nation’s health care industry moves from paper files to computerized records. The momentum is expected to pick up this year as federal stimulus money to help with the transition is starting to arrive at doctor offices and hospitals across the U.S.

Already, hundreds of hospital operators nationwide, including the largest ones in the Chicago area such as NorthShore, have entered the digital age, allowing patients to access email alerts to remind them of appointments, request medical test results or easily connect with insurance companies, pharmacies and other key players of the health care system.

Industry observers project the digitizing of medical records could save the nation’s health care system hundreds of millions of dollars because it would reduce or eliminate redundant testing and the occurrence of errors in patients’ files, among other benefits.

It is just a matter of out of sight, out of mind until you experience first hand the benefits and convenience provided by electronic records. In the digital age, when we communicate at literally the speed of light about mundane details such as where we bought our coffee this morning (I went to Peet’s), it seems like a no brainer to use this amazing communications infrastructure to increase our health too.

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Doctors are great scientist but many are lacking when it comes to business acumen. It is actually kind of amazing that in a profession where so much is made of taking care of yourself now to prevent problems later in life, the same approach is not taken when it comes to running a business.

Wall Street Journal, April 11, 2011

The reasons for not adopting electronic medical records are pretty straightforward: those on the sidelines think the systems are expensive, that they won’t produce a return on investment and that they’ll cut productivity even after they’re fully implemented.

So finds a new survey, conducted by the Medical Group Management Association and covering 4,588 health-care organizations, including independent practices, hospitals, integrated systems and others. Some groups were still using paper records and others reported being at various stages of implementing electronic ones.

Among those using paper charts, 78% believed there would be a “significant to very significant” loss of productivity during the switchover to an electronic system, and 67% believed productivity would be lost even after implementation. Almost 72% cited a plain old lack of cash as a barrier to digitizing records, and 57% said they didn’t believe there’d be a return on the investment.

(A separate survey released in February found growing skepticism among physicians about the financial and other benefits of EMRs.)

Among those who’d adopted electronic records, those who considered the systems up and running to their best capability were more satisfied than those still optimizing their use.

One interesting tidbit: of those groups using electronic records, 53% said they either “mildly” or “severely” underestimated the time needed to train people to use the systems. The WSJ recently reported on the challenges of training physicians and other care givers to use newly purchased electronic medical record systems.

Among the comments, some from physicians, received by MGMA: “Doctors felt like they didn’t need much training … However, when they went live they wished they had trained for more scenarios.”

As with all technology, cost will eventually go down over time and more people will adopt these systems. I just wish the future was now.

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Dermatology offices offer a unique set of challenges for the implementation of electronic medical records. This is because many dermatology offices offer cosmetic, cash only, procedures. For offices that do a lot of cash only procedures, EMRs are not especially useful for tracking health and medical history. That doesn’t mean an EMR system shouldn’t be implemented though. Physicians in the cash pay industry generally have to think more like businessmen than their counterparts in the insurance pay side of medicine. This is due to the fact that when the consumer is paying cash, there are more options available for them to seek out the services they are looking for. How will the average person off the street know that a dermatologist is offering services like laser hair removal? The medispa down the street gets the word out through advertising so to be competitive a doctor will have to do the same.

The necessity to create an advertising budget will inevitably require budget cuts in other areas of a practice. This is where the addition of EMRs can help save money. Even though there can be a substantial up-front cost for switching over to an EMR system, the efficiencies create long-term savings making the investment well worth it. This savings can then be rolled over into a marketing budget to stir up more cosmetic patients and more money in physician’s pocket.

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