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VISION — EMR: Keeping it Simple
From The Journal of Medical Practice Management
Volume 25, Number 3, November/December 2009



A "KISS" EMR May Be All You Need

W. Allen Clifford*

               

The Obama Administration has continued where the previous one left off in advocating the widespread adoption of electronic (digital) medical records (EMRs). But an expensive EMR system loaded with bells and whistles that you don't really need, and requiring doctors to interact with computers, can cost you in terms of patient-care time as well as money. The Big Three elements of a practical EMR system are electronic visit notes (which can encompass dictation/transcription), drug prescribing, and lab test ordering/results. An inexpensive "KISS" (Keep It Simple, Stupid) EMR containing these basic elements, and not requiring disruptive changes in office routines, may be all you really need.

               

The Obama Administration has continued where the previous one left off in advocating the widespread adoption of electronic (digital) medical records (EMRs). But there has been no such edict as, "Thou shalt be required to implement a very expensive EMR loaded with bells and whistles that you don't really need." Sometimes less can be more.

Let's not take our eyes off the ultimate goal of the policy, which is not to burden medical practices with unwieldy EMR systems, but simply to have the basic health record in an electronic format that is easily accessible by any healthcare provider who needs it. This will help to provide patient care in a more efficient manner with less chance for error due to miscommunication.

 

There has been no such edict as, "Thou shalt be required to implement a very expensive EMR loaded with bells and whistles that you don't really need." Sometimes less can be more.

 

It seems that in October 2011, Uncle Sam will begin allocating billions (with a "B") of dollars in "Stimulus" money to help ensure that records become electronic within five years and that healthcare information technology (HIT) is utilized "in a meaningful


*Resource Providers, Inc., 4511 N. Himes Avenue, Suite 262, Tampa. FL 33614; phone: 813-282-8889; toll-free: 866-660-4774; fax: 813-282-1400; e-mail: allenclifford@rpiusa.com. Copyright @ 2009 by Greenbranch Publishing LLC.

               

way" (a phrase, from the legislation's wording, whose meaning is open to interpretation). Earlier this year, the federal government's 21-member HIT Standards Committee held a hearing on Meaningful Use.

Writing on May 12 in his "Straight Talk" blog, SRSsoft CEO Evan Steele noted that during the hearing, Dr. David Classen from the University of Utah cited a study revealing that a number of EMRs already certified by the Certification Commission for Healthcare Information Technology (CCHIT; see below) "did not fare very well in meeting several test measures of improvement in quality of care." 1

The point was also made that an EMR needs to be functionally usable not only by primary care physicians (the providers around whom the "meaningful use" discussion continues to be based), but also by high-volume specialists who have less time, if any, to spend inputting data into a computer.

Those points seemed to come as news to the 21 committee members, none of whom represents high-volume doctors or alternative EMR technologies. And citing a recent study in Medical Economics in his April 29 entry, Steele points out that allowing an EMR to automate E/M coding "has led to severe financial and legal repercussions for practices" in that it "raises a red flag with payers, and EMR documentation does not stand up well in the resulting audits." 2  Patient visit notes need to be sufficiently comprehensive, and EMR-templated notes are often lacking.

  
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