P.S.
Michael, do you think it would be worthwile for me to
attend the VistA office meeting, or is it primarily
targeted for venders?
Thanks,
Kevin
--- Michael Ginsburg <[EMAIL PROTECTED]> wrote:
> That makes a lot of sense and is one of the
> potential ROI's for an EHR
> that has been overlooked. Will they offer a discount
> for physicians that
> use EHR's? Are there circumstances under which they
> would consider
> offering a discount?
>
>
>
> >>> [EMAIL PROTECTED] 10/19/2004 12:10:20 PM >>>
>
> Well, the company is State Volunteer Mutual Insurace
> Company, and it is physician run an owned. They
> have
> regular education programs with the idea of
> promoting
> good practice patterns to AVOID malpractice cases in
> the first place.
>
> I guess they believe that an EMR will reduce
> malpractice events.
>
> Kevin
>
>
> --- Michael Ginsburg <[EMAIL PROTECTED]> wrote:
>
> > Kevin,
> >
> > I am most interested in your first sentence. Why
> is
> > your medical
> > malpractice company hosting the conference?
> >
> > Mike
> >
> > >>> [EMAIL PROTECTED] 10/19/2004 8:17:45 AM >>>
> >
> > Hello all,
> >
> > In Tennessee, our medical malpractice company is
> > hosting an EMR conference this December (and why
> it
> > is
> > them is interesting) . My office manager and I
> will
> > be attending at the request of my medical group.
> > The
> > group had previously agreed (tenatively) to go
> with
> > VistA, but they still want me to look at other
> > alternatives. I haven't seen the actual report,
> but
> > I
> > have heard that AAFP is now "strongly
> recommending"
> > that physicians get an EMR system. I think this
> > will
> > push many into buying in--perhaps for fear of
> > liability if something happens after such a strong
> > directive is ignored. This will be an business
> > expense, not an investment, because there will be
> > little (and I suspect no) financial return on this
> > expendature.
> >
> > But frankly, I worry that this will be an
> expensive
> > wild goose chase. I believe the power of an EMR
> > will
> > not be realized unless there is interoperability.
> > For
> > example, if labs are not obtained in a standard
> > format
> > that could be shared with others, then users will
> > end
> > up scanning the report and storing it as a
> graphic.
> > This is no better than a paper chart. And while
> > many
> > labs probably have such an interface, I know that
> my
> > hospital doesn't. And I suspect a majority of
> small
> > hospitals don't (and remember that MUCH of
> America's
> > health care is given by small practices working
> with
> > small hospitals).
> >
> > So after AAFP and other organizations push doctors
> > into coughing up the $100-200k needed to get a new
> > system up and running, will patient care be
> better?
> > I'm not convinced it will. I have heard that
> > thought
> > leaders feel that a good EMR could achieve a 20%
> > reduction in health care expendatures. But unless
> > my
> > EMR will somehow let me instantly access a
> lab/study
> > ordered by another physician in another city, I
> > don't
> > see how this could happen. And now system I have
> > seen
> > addresses this issue. With HIPPA nervousness
> > abounding, no one will release records without a
> > written signature from a patient, and I not heard
> of
> > any quicker electronic solution to this problem.
> >
> > I keep a relatively well organized paper chart
> with
> > tabs etc. It is fast and complete. It easily
> > stores
> > the carbon copies of scripts that I write, letters
> > that patients write me, copies of their advance
> > directives etc etc. All these things would have
> to
> > be
> > scanned in an EMR, and then possibly lost in a
> > shuffle
> > of filenames (i.e. "image1462"). My charts are
> > portable: they can travel in the car with me, or I
> > can
> > take them to the hospital when admitting a
> patient.
> > They're flexible: I could have a visit in a
> > patient's
> > home if required (i.e. I don't have to have a
> > computer
> > station set up.) They're "hi-res": Most computer
> > screens have to magnify the image so that a
> scanned
> > image is readable. Thus a full scanned page often
> > won't fit on a screen and still be legible. So
> you
> > have to scroll around. Paper doesn't have this
> > problem.
> >
> > As one who has put in a significant amount of time
> > working with VistA, I don't want to sound like a
> > Luddite anti-technologist. But I am seriously
> > concerned that physicians are being pushed into
> > making
> > a sudden technology change away from a system that
> > has
> > withstood the test of time. I'm also concerned
> about
> > a
> > "lock-in" issue. I suspect that none of us use
> the
> > same word processor that we did 10 years ago, but
> > rather technology has progressed and we regularly
> > purchase the latest and greatest. But will
> > physicians
> > be willing to purchase system after system the way
> > we
> > do computers now? I doubt it. If our group buys a
> > non-VistA EMR, I imagine we will keep it at least
> 10
> > years. We'll be locked into 2004 technology until
> > 2014. (Our current system is 1980's technology)
> >
> > So what do I think the solution is to all this?
> > Well,
> > VistA goes a long way. First, it is easily
> > conceivable that VistA could be established in an
> > office for ~$10-20k, one-tenth the cost of a
> > commercial system. (And my goal is to make the
> cost
> > much less than this). This will make it much less
> > painful for small practices, and still quite
> > attractive for vendors (multiply the "272,428
> > practices" below by $10,000 makes for a nice
> > retirement plan.) And if we have a critical mass
> of
> > physicians on the same system, we have more chance
> > of
> > interoperability.
> >
> > So in summary, I support getting EMRs into
> > physicians
> > offices, but I think we need to have realistic
> > goals.
> > We need to provide inexpensive solutions, and plan
> > for
> > gradual transitions. And VistA has a great
> potential
> > meeting some of these goals.
> >
> > Hope to see you all at the WorldVistA conference.
> >
> > Kevin
> >
> >
> >
> >
> >
> > --- Joseph Conn <[EMAIL PROTECTED]> wrote:
> >
>
=== message truncated ===
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