Wherever I go in my travels as a locums physician, I assess the EMR (electronic medical records) systems. As I’ve written before, there are good and bad systems. But one consistent them I see is this. I find a place with a good, simple system. (I’m using EMpower this week.) The doctors and nurses like it. I learned to use it in about 15 minutes and it produces a good record.
But reliably, the doctors and nurses who use good systems say this, with a sigh: ‘It’s good and we like it. But they’re replacing it because it doesn’t communicate with the computerized order entry,’ (or with the inpatient side, or with the billing company). There’s no ‘patch,’ as it were. ‘It’s too expensive to make the patch.’
So, the hospital will spend hundreds of thousands of dollars, or the system millions, for a new, shiny EMR that doesn’t need ‘the patch.’
I believe that ‘the problem of the patch’ is a lie. I believe that it’s a ruse, a subterfuge to take away systems that are simple and that allow for efficient patient care, and replace them with costly systems that are designed to make life easier for insurers and coders and simultaneously make oodles of money for those involved in the transaction and implementation.
I can talk to my wife on Face-time using my i-Phone. I can scan documents and send them via the same phone. I can teleconference on my laptop across the country or world. My computer and phone can do things unimaginable even 20 years ago. Scientists are ‘beaming’ particles across space. NASA is experimenting with a microwave drive that might propel spaceships to Mars in three weeks.
And nobody can make a patch so that systems communicate? Nope. I don’t believe it.
It’s peculiar that we as physicians were told to avoid any appearance of financial impropriety with drug companies…even pens would sully our pure souls. But for administrations to adjust their records keeping to jack up charges on every single breath taken in the ER is simply good medicine. How is that again? I’m confused.
Next time they tell you there’s ‘no patch,’ take it with a grain of salt.
Because it sounds as valid to me as that dog that ate all of that Percocet.
I too have seen this, twice as a locum doc in two years. Wellsoft (Which deserves to be on your list of “good” emrs was replaced with a bad one (Allscripts Sunrise) at one facility and a mediocre-good one (Cerner Firstnet/Powerchart) at another. The Wellsoft people told me they had the patch. The scuttlebutt in the hospitals was that the patch was either too expensive or not sufficient to “guarantee Federal HiTech act money” Someone is making a buck here, making our lives miserable in the process. And hurting patients and the hospitals real world bottom line during the roll… Read more »
Scot DePue
10 years ago
This is so on the mark. I have been doing fulltime locum tenens work for two years. Nothing makes or breaks a locum doc as much as the EMR. I have been at TWO systems that replaced Wellsoft (the number one ranked EMR) , one with a fair system (Cerner) and one with a dog (Allscripts Sunrise) At both sites, the Wellsoft people said that they offered the patch but the hospital declined, citing cost. The cost of poor throughput is hard to quantify, but it must at least approach the cost of the patch. I saw my own patient… Read more »
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I too have seen this, twice as a locum doc in two years. Wellsoft (Which deserves to be on your list of “good” emrs was replaced with a bad one (Allscripts Sunrise) at one facility and a mediocre-good one (Cerner Firstnet/Powerchart) at another. The Wellsoft people told me they had the patch. The scuttlebutt in the hospitals was that the patch was either too expensive or not sufficient to “guarantee Federal HiTech act money” Someone is making a buck here, making our lives miserable in the process. And hurting patients and the hospitals real world bottom line during the roll… Read more »
This is so on the mark. I have been doing fulltime locum tenens work for two years. Nothing makes or breaks a locum doc as much as the EMR. I have been at TWO systems that replaced Wellsoft (the number one ranked EMR) , one with a fair system (Cerner) and one with a dog (Allscripts Sunrise) At both sites, the Wellsoft people said that they offered the patch but the hospital declined, citing cost. The cost of poor throughput is hard to quantify, but it must at least approach the cost of the patch. I saw my own patient… Read more »