Electronic medical records, BAD!!!

[Guest sdgpac]

How has EMR impacted your practice? I work in an office, IM/Peds, see 20-25 pts a day, and have been using EMR (EPIC) for about 18 months. It SLOWs down everything, can put me behind 30-60minutes, and creates 2 hours of chart work at home (can access EPIC from home). It is so much quicker to hand write a note. I hate it!! Especially bad when pt's have 3 or more c/o at same visit.

 

Anyone with positive experience?

[Iain1028]

When I did my IM rotation, the EMR the doc used was so antiquated, it was like something from Russia.

 

It took forever to add and edit, I ended up filling it out while interviewing the patient, I had no choice or I would be in there an hour. I had to turn my back to pt while asking questions, but I always apologized for that.

[andersenpa]

How has EMR impacted your practice? I work in an office, IM/Peds, see 20-25 pts a day, and have been using EMR (EPIC) for about 18 months. It SLOWs down everything, can put me behind 30-60minutes, and creates 2 hours of chart work at home (can access EPIC from home). It is so much quicker to hand write a note. I hate it!! Especially bad when pt's have 3 or more c/o at same visit.

 

Anyone with positive experience?

 

I use Epic and Cerner PowerChart. There are more positives than negatives.

 

Particularly the immediate access to an up to date med list, problem list hx, integrated imaging storage, and other provider's notes (especially in a hospital w/ remote satellites whose notes are available on the date of service).

 

A dictation component is helpful but a small practice might not have that service.

 

After a few yrs of using it, when you follow pts longitudinally w. the EMR, it may seem more useful.

[Zeus]

We used EMRs at my last rotation and my current workplace. Definitely has its advantages as well as disadvantages.

 

For me, its quicker to sift through the an EMR than a paper chart, not to mention that i type alot faster than i can write even with shorthand. Everything is there, that is nice and for the most part you can read everything from previous providers notes. Down side for me was the learning curve, bugs within the system and it is limited by the network which is the most annoying part. Our scripts are electronic as well which is nice when it work ;)

[LESH]

So Zeus you're working? Fantastic, please shoot me an email about where they have you working- your primary and secondary (if applicable) site(s). Are they treating you okay so far?

Les

[thinkertdm]

Just want to say that EMR's aren't bad; poorly written software is. It's interesting that I can log in to my bank account and do all sorts of interesting things with my money in seconds, but I need to jump through fifteen different hoops to get basic functionality on most EMR systems I've used.

 

EMR's are pretty much universally poorly written by people who don't understand the workflow. I've used CHCS 2, Essentris, and AHLTA in the military system- three systems for a network of military hospitals, and not only are they unwieldy (to say the least), they are down more often than they are up. Despite these 3 systems, soldiers being evac'd still have hand written (or printed) notes stuck in a folder under their leg on the stretcher. I'm sure the idiots who wrote those EMR's are cracking up on the way to the bank.

[brianprepa]

At first it does seem to slow down the patient encounter. That gets better over time as you get more accustomed to using the system. However, EMR has been proven overwhelmingly to correspond with better patient care. The overall efficiency of the office is improved which translates into seeing more patients and fewer mistakes being made. Besides the learning curve, another problem is that most of the good EMR systems are expensive. Because of that, inferior software is often selected, which actually does hinder progress and workflow. There are several good choices though. The office where I work uses E-MDs and it is absolutely wonderful (but somewhat expensive). There are a couple good open source options--OpenEMR is already used in thousands of offices and PatientOS is in final stages of production and should be ready by year's end. The software makes all the difference! My personal choice is that I will never again work at a place without EMR, even if they do have a poor EMR system.

[SocialMedicine]

I am computer savvy and accustomed to my practice EMR. Been using it for just under 2 years now. Good for patient care, bad for time management. Initially the record is not so great for patient care either. It is difficult to manage two charts ( the paper and electronic ). I tend to spent 10-15 minutes before every day reviewing all paper charts for patients, and during the visit viewing the electronic. I could def see medical errors and repeat testing/vaccination occurring bc of this.

[bobuddy]

We have used EMR (Practice Partner) for about 8 years now. There was definitely a learning curve for awhile. I love it now. I also have the ability to log in from home. It helps when you are on call and a patient calls about a medication and you can look it up easily - fax a prescription, etc.

[JFarnsworth]

I have used EMR for about 6 years now, and after front loading a lot of time into the system, it gets easier. Templates! That's all I can say. Yes it seems like there are a million to set up, but once you do, and if you've set it up well, then it's 2 minutes and your chart is done. They have some "smart templates" that you can tweak as well. I was one of the beta testers for ours when we first started using EMR, and that was not fun, but every system has its glitches and I think eventually it will get better, especially if medical professionals are involved in the programming. You also don't have to rely on the patient remembering what was prescribed, or "some test" that was done, you can look it up and get the results, which I think is a bonus. My 0.02 cents.

[Aleah]

Does anyone have any experience with practice fusion? I was supposed to join a webinar on it today, and my screen was blank the whole time. Not off to a good start with this one!

[jmj11]

Does anyone have any experience with practice fusion? I was supposed to join a webinar on it today, and my screen was blank the whole time. Not off to a good start with this one!

 

My new clinic is starting with Practice Fusion. I've done a lot of training on it and have been practicing. We see our first patient next Tuesday, so the real-life testing has not occured. There's a few things that bug me. I've totally rewritten the templates for patient encounters but there was no drop-down bar to pick variables. You can only leave blanks, which you must type in. Also the prescription software requires you to mannually populate the information for the pharmacies, except for major nation-wide chains.Also, you must choose your professional title. If you choose the "NP, PA, RN," box (they are together) you are treated like a medical clerk by the software. So to really use it, you must list yourself as an MD (the software writers don't have a clue what we do in real life). Then, there are times, so it seems, it will put a default with your name as "Dr.". But, if you don't list yourself as a MD or DO, then the software isn't fully assessible to you.

 

But, on the bright side it is FREE. Having now spent 40 K and yet to see my first patient, anything free is a good thing.

 

Mike

[d2305]

How did it go? The headache template is not that good, but I have used it a few times.

[jmj11]

How did it go? The headache template is not that good, but I have used it a few times.

 

 

Actually, I misquoted, our first patient is tomorrow. I totally rewrote all the templates. The headache one was from the 1960s. I don't use any of theirs.

[sk732]

We're starting to use one in the Canadian Military - Purkinje - which has it's pros and cons. Big con is the first time you do a full medical on someone, there is about 30-45 minutes of work before or after just filling in family and past med/surg histories. After it's done though, you just tweak it as you go. The other problem is someone with multiple issues is a pain - they only give you 3 spots in each of the different historical blocks to fill stuff in..annoying. AND all Dx are based on ICD-10 diagnostic codes - some are really specific, others really general and you have to think like a supply clerk to sort it out. Also, no codes for procedures if you do any...so there are text boxes you can add to give the diagnosis, but you still have to have an ICD-10 in there or else it won't let you electronically sign. If I hand write my H&P's, and do the physical, it's usually 45 min for an in depth medical and a couple of minutes to dictate my notes after...now I need about an hour and a quarter due to typing, playing with drop downs, etc, even though there is a template. I have my office set up so that the patient sits beside me while we're chatting so my back isn't to them and they can see some of what's happening, but I interview and type simultaneously. Pros - I can quickly find something, in proper chronological order, quickly by category - specialist consults, labs, DI, etc. as well as ongoing primary care issues, meds/pharmacy fills, and their medical profile. I'm still not totally sold on the manual entry, as I'd prefer dictating, but due to money and security issues, they're discouraging us from using Dragon Speak, but I'm not as time constrained in my current job as I was elsewhere, so it'll do.

 

Sean K

[winterallsummer]

Has anyone ever heard of a hospital operating ONLY on EMR, i.e. no paper charts or basically no use of paper charts other than signed papers and face sheets etc? Would you want your hospital to do this?

[Contrarian]

MEDTUITY...!!!!

 

Inexpensive, fast, Tablet Optimized...

[Magicnubs]

There are growing pains, surely, but I doubt anyone would argue that EMRs will not eventually become much more a benefit than a burden. Most of the hurdles are already able to be overcome and will be dealt with more and more quickly as the hardware and software get better and cheaper (e.g. having to stand in front of a computer can be fixed by practices using tablets which are quickly getting better and cheaper.)

 

The earlier we adopt EMR and adapt to it the better.

[andersenpa]

Has anyone ever heard of a hospital operating ONLY on EMR, i.e. no paper charts or basically no use of paper charts other than signed papers and face sheets etc? Would you want your hospital to do this?

 

My hospital is essentially all EMR. The clinic side is phasing into a more complete EMR mode as well. There are a few services that are still using some paper documentation but all the primary service lines use EMR and CPOE. It's incredibly useful and fast once the system is implemented and the staff all have basic functionality.

[d2305]

You can't get cheaper than free.

[DebSumm]

My new clinic is starting with Practice Fusion. I've done a lot of training on it and have been practicing. We see our first patient next Tuesday, so the real-life testing has not occured. There's a few things that bug me. I've totally rewritten the templates for patient encounters but there was no drop-down bar to pick variables. You can only leave blanks, which you must type in. Also the prescription software requires you to mannually populate the information for the pharmacies, except for major nation-wide chains.Also, you must choose your professional title. If you choose the "NP, PA, RN," box (they are together) you are treated like a medical clerk by the software. So to really use it, you must list yourself as an MD (the software writers don't have a clue what we do in real life). Then, there are times, so it seems, it will put a default with your name as "Dr.". But, if you don't list yourself as a MD or DO, then the software isn't fully assessible to you.

 

But, on the bright side it is FREE. Having now spent 40 K and yet to see my first patient, anything free is a good thing.

 

Mike

 

Also, if you choose the "Np/PA" option when you prescribe, you are automatically assumed to be an NP and your electronic signature is written that way. So you have to always add a "Comment" that your title is really PA-C. Very, very annoying.

[EMEDPA]

Also, if you choose the "Np/PA" option when you prescribe, you are automatically assumed to be an NP and your electronic signature is written that way. So you have to always add a "Comment" that your title is really PA-C. Very, very annoying.

given those options I would pick MD/DO then add in the comments that I am a PA.

[HopefulPA]

I just changed jobs and the last one was a lot further in implementing EMR, infact a month after I left they went paperless and dictationless. Now I am back to the infancy stages of EMR. Have to do H&P in EMR but other notes can be hand written. medication rec have to use EMR. other than that everything else is hand written orders. I miss my EMR a lot more than I thought I would. I really miss the EMR.

[jmj11]

How did it go? The headache template is not that good, but I have used it a few times.

 

I just saw this response. Actually, I spent hours totally gutting Practice Fusion. I use none of their templates. I've created about 10 that are as specific as "Cluster Headache Follow Up" and "Facial Pain New Patient." I'm getting along with them better, but I still hate (with a passion) their response letter. Takes 20 minutes to send one fax.

[Contrarian]

^^^ As the saying goes... "You get what you pay for"...!!!!

 

Try

MEDTUITY

...!!!!

 

Inexpensive, Adaptable, Fast, Tablet Optimized...

 

4.

With Medtuity, you avoid the high up-front expenses associated with other EMRs, because there is no cost to acquire the software and no contracts to sign. Our pricing model is simple: there is a low per-patient charge. See

Pricing

for more details.

5.

Whether you have a staff of five or 50, there is never a charge to acquire the MedtuityEMR software. If you wish to add staff and computers, we do not need to know about it. As your practice grows, you will simply continue to pay a low per-patient charge.

6.

Software updates are free. The most common updates are to MedtuityEMR's clinical content, scripts and instructions. These are quickly and easily downloaded over the internet using an automated interface in the MedtuityEMR software.

 

 

“Medtuity increases our office efficiency and quality of notes. My staff is more efficient thus reducing the need to hire additional help in the office.”

-Lenora Fitton, D.O.

ABC Pediatrics

 

 

MedtuityEMR Pricing

MedtuityEMR pricing is simple: "75 cents for 'Elvis-is-in-the-building'."

Simply stated,when a patient comes to your facility for care, a new patient encounter is created. For that, one credit is consumed from the bank of credits that you purchase.

Users are not charged a credit to append to a previous encounter.

What constitutes a patient encounter?

A patient encounter is best characterized as a patient's visit to the doctor. In other words, if a practitioner can touch and feel a patient, then a new encounter is usually started.

An encounter may be appended to without consuming further credits, and multiple healthcare workers may contribute to an encounter at no additional charge. The user decides what constitutes a new encounter vs. appending to a previous chart.

Risk Free Pricing

MedtuityEMR's risk free pricing includes:

• No upfront costs
  
  

What do you get for $0.75?

• Incremental updates
  
  

After the initial training each facility typically has a user that is capable of showing new employees how the program operates in 1-2 hours. Onsite training is provided during the first 30 days and online training can be arranged after this time.

Credits

To use MedtuityEMR, users buy credits. Credits are usually purchased in increments of:

• 1000
  
  
• 2500
  
  
• 5000
  
  

For example, 2500 credits cost $1875.00 and will allow a facility to document for 21 weeks at 30 patients per day, 4 days per week.

When MedtuityEMR runs low on credits, an alert appears, and an email is automatically sent to the administrator.

Adding New Features

MedtuityEMR derives great functionality from users describing how they can achieve greater efficiency with a special request item.

New features are added with our incremental updates which occur monthly. All features added to MedtuityEMR have been universal items that have benefited all users. Should anyone request a feature that will be used by a majority of MedtuityEMR users, there will be no cost associated with adding it.

 

 

 

Btw... I have NO financial interest in Medtuity. I use it in my clinic and it is a GREAT program.