EHRs are tools, not solutions

Yesterday, one of the residents in my program sent me an e-mail with this link:

Residents Skip Lectures to Catch up on Electronic Health Record (EHR) Charting
http://www.medscape.com/viewarticle/812566?nlid=36143_589&src=wnl_edit_medn_fmed&spon=34

Here is my response to her:

EHRs by themselves can’t make offices more efficient and often have the converse effect, like we are experiencing here.  As long as EHRs are used as data repositories and nothing more, they offer little advantage over dictating (though I, having mostly grown up with EHR, am far more efficient on EHR – even a bad one like ours – than dictating).

The only way EHRs make offices work better is when offices transform their practice around FULLY FUNCTIONAL systems.

What is a fully functional EHR?  One integrated with an automatic patient history program like Instant Medical History (http://www.medicalhistory.com/home/index.asp); a patient portal allowing e-visits and easy, asynchronous dr-pt communication; and the ability to easily create and maintain patient registries.  Along with a modern office workflow that emphasizes teamwork with a family doc leading nurses, MAs, pharmacists, and physician extenders, EHRs can then make doctor’s and patient’s lives better.  Under this model, docs only see patients for about 50% of the day, leaving the rest of the day to do e-visits, connect and coordinate care with patients using the patient portal, and take care of refills and other paperwork.

But a system without those essential components, plunked into an office still operating with mid-20^th century processes?  Disaster.  

EHRs are not a magic solution in and of themselves.  They are a tool to help us realize that better vision of 21^st century patient-centered care.

If you can find this book online or in the library, it is worth a read – even if you just read the speech about “Dr. Olderway” and “Dr. Youngerway”:

http://www.amazon.com/Escape-Fire-Designs-Future-ebook/dp/B008NBZ972/ref=sr_1_3?ie=UTF8&qid=1382468338&sr=8-3&keywords=escape+fire

I am excited to see your interest growing re: systems of care.  Our specialty needs people who are unafraid to challenge the status quo!

Jen

And that's all I have to say about that.

Juggling act

I'm feeling guilty about the Singing Pen right now.  Seems that this blog is getting the short end of the stick, lately, with my contributing to the AFP Community Blog, slogging through data entry on a research project, and trying to keep plugging away on my novel draft.

And yet, with all of that going on, this blog is still frequently on my mind. I still have ideas on a regular basis that could prompt a post, but I never get around to actually typing them out and getting it out there.

One of those ideas relates to the summer URI that I have recently recovered from. I have never called off work for a cold before, but this virus was a doozy.  I spent two days at home huddled on the couch with a box of tissues, watching a stream of stupid TV shows in a vain attempt to distract my psyche from my nose and sinuses.

That first day when I start to feel better is always a really good one, though.  I'm reminded to have gratitude for my overall good health and my ability to recover.  I always realize, looking back over the days of missed work (and not blogging or data-entry-ing or writing) that the world will still rotate just fine without those activities - and, that sacrificing exercise and good nutrition to get them all done will have consequences.  Those are the days that inspire me to restructure the juggling act.

I know it won't last; somehow, having a plate that is overflowing just a tad feels comfortable to me.  Or, rather, having empty space on my plate, even a sliver, makes me feel like a slacker.  So, I'm diving back in to all of the things I like to do, knowing full well that I probably should back off on something a bit.

But I'm confident that a virus will always be waiting to remind me that there's a better way.