Doctors know they are going to have to go to electronic health records. Right now, in all but 10% of doctors’ offices, when you arrive they have to find your chart, pull it, and put it in a plastic folder at the door to the examining room they stick you in to wait. The frantic doctor will glance at it quickly as he walks into the room. Perhaps the nurse or a medical assistant will have taken the vitals and entered them. Perhaps your latest lab tests are in the chart, which can be a thick folder, and perhaps they are not. The doctor is trying to see forty patients a day to cover his overhead, most of which is related to paperwork.
You know the drill. As a consumer, you pray for an electronic health record, for both you and the physician(s) you visit. You would love to quit filling out the same form over and over. But the doctors, who now have acres of paper records, are terrified to automate their practices. What if they inadvertantly violate HIPPAA? What if the network goes down? How can we afford the expense? How do we know what to buy? What if we don’t type? How do we get the records into the EHR from the paper charts? Won’t this make me slower and less productive, at least in the beginning.
These are all good and valid questions. I remember them from when billing and claims processing software first came out. But the government, the largest healthcare payer in the country, is going to mandate EHRs pretty soon, just the way it mandated claims processing. One day you could no longer submit claims to Medicare unless you did it electronically, and everyone out and bought software, engaged a clearing house, bit the bullet.
The move to paying providers on the basis of outcomes is just around the corner, and it’s a prime reason why doctors MUST automate. They will need to access a lot of data to prove they are doing a good job, not just for Medicare, but for every other insurer. This will come fast now, because the technology is really there, and the world knows it.
I belong to a not-for-profit called the Arizona Health Information Technology Accelerator.
We have trained ourselves in all the major products, and developed a process to help each different practice evaluate what’s best for it. We represent nobody. In fact, we know what’s wrong with EVERY product. All we want is to see medical practices get to the point where the patient is not the victim of poor record keeping and business inefficiency. I still don’t have the results back from my annual Pap Smear, which I had two weeks ago. I know the results were available from SonoraQwest online the day after the exam. But my doctor either didn’t look or printed them and shoved them into a file folder somewhere without calling me.
That’s what motivated the startup of AHITA. AHITA is now at the point where we can go into a practice on a consulting contract, help them choose the “right” (or the least wrong) product, and help them implement it — deal with the change management and work flow issues. We are totally up front about how difficult it will be, but we can shortcut a lot of the time-consuming up front work. We can also make it a bit easier to get up and running on EHRs. And because we are a not-for-profit, we don’t have to charge the kind of fees the big firms charge.
It’s a tough transition, but I remember when Intel went to SAP ten years ago and that was a tough transition, too. Now it’s a product they love. Or at least one they need to have in order to remain competitive. Not to mention that Intel originally had a choice about whether to automate its enterprise resource planning, and the doctors won’t have that choice. They are too far behind the technology curve.