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Everyone hates the electronic medical record

logicmag.io

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Re: Everyone hates the electronic medical record

#11

Post by Spivak »

KennyBlanken wrote: post #8

> Patient R was in a hurry. I signed into my computer—or tried to. Recently, IT had us update to a new 14-digit password. Once in, I signed (different password) into the electronic medical record That's IT infrastructure incompetence, not an EMR issue. At the two healthcare systems I go to, both utilize RFID badge readers plus PIN. In the ER and urgent care, nurses need only tap their badge and enter a quick pin and…

> That's IT infrastructure incompetence, not an EMR issue.

The two cannot be unlinked so easily when I have never met someone so doesn't have the same story of hospital IT. Even the IT workers hate hospital IT. The deployment of an EMR has to take into account the regulatory and security requirements imposed on all digital systems.

> I get emails notifying me I have a "message", instead of even offering me the option of receiving an email with the actual message.

You need to bash the right heads together and get your email provider and sender in DirectTrust https://directtrust.org/what-we-do/direct-secure-messaging

Not gonna say it's not a bitch and a half to implement but you can send sensitive data directly via email. And if you're the SaaS provider you're part of DT that's a huge value add for your offerings.

Re: Everyone hates the electronic medical record

#12

Post by timekiller »

FwarkALark wrote: post #7
JusticeJuice wrote: post #4

I wrote a thesis on EHR's 7 years ago. They really haven't seemed to improve much. I personally think a big part of the issue is actually scope, these systems are expected to do everything - medical notes, script ordering, appointment management, billing of course, and 3000 other things. This weirdly leads to a distribution problem, you can't be a serious competitor in just one area, you have to do everything. Only t…

Is this something where a public competitor might help? It surely can't be worse than private industry.

Oh it could be much worse. You should see how bad government run HIE’s are.

Re: Everyone hates the electronic medical record

#13

Post by mrcarruthers »

KennyBlanken wrote: post #8

> Patient R was in a hurry. I signed into my computer—or tried to. Recently, IT had us update to a new 14-digit password. Once in, I signed (different password) into the electronic medical record That's IT infrastructure incompetence, not an EMR issue. At the two healthcare systems I go to, both utilize RFID badge readers plus PIN. In the ER and urgent care, nurses need only tap their badge and enter a quick pin and…

The email thing is probably a privacy requirement. Email isn't encrypted meaning your email provider (and the EMR's) can fully read the contents of said email.

Re: Everyone hates the electronic medical record

#14

Post by nradov »

FwarkALark wrote: post #7
JusticeJuice wrote: post #4

I wrote a thesis on EHR's 7 years ago. They really haven't seemed to improve much. I personally think a big part of the issue is actually scope, these systems are expected to do everything - medical notes, script ordering, appointment management, billing of course, and 3000 other things. This weirdly leads to a distribution problem, you can't be a serious competitor in just one area, you have to do everything. Only t…

Is this something where a public competitor might help? It surely can't be worse than private industry.

There is (or was) a public competitor. VistA was largely developed by the federal government. Some organizations still use it and it's available for free, but independent reviews have generally rated it as worse than the private industry products.

https://worldvista.org/AboutVistA

Re: Everyone hates the electronic medical record

#15

Post by nradov »

sixothree wrote: post #6
JusticeJuice wrote: post #4

I wrote a thesis on EHR's 7 years ago. They really haven't seemed to improve much. I personally think a big part of the issue is actually scope, these systems are expected to do everything - medical notes, script ordering, appointment management, billing of course, and 3000 other things. This weirdly leads to a distribution problem, you can't be a serious competitor in just one area, you have to do everything. Only t…

Yea. But in that time there has been an absolute revolution in what can be done with that data. FHIR specifically has completely changed the landscape.

FHIR is great for interoperability but it doesn't really do anything for the EHR user experience.

Re: Everyone hates the electronic medical record

#16

Post by happytiger »

timekiller wrote: post #12
FwarkALark wrote: post #7

Earlier quoted context omitted.

Is this something where a public competitor might help? It surely can't be worse than private industry.

Oh it could be much worse. You should see how bad government run HIE’s are.

To back you up. They are profoundly worse. It’s an area where private dominates entirely, as the government HIEs are almost unusable.

Re: Everyone hates the electronic medical record

#17

Post by NoPicklez »

jackvalentine wrote: post #3

Disclaimer - I work for a health service that isn't in the USA and has a very extensive EMR. I don't disagree. I started my career dealing with paper folders of records that were fastidiously organised by a team that made sense of them. Now everything is electronic and fucking _everywhere_. The work didn't go away - but giving everyone a computer made it everyone's problem and nobody's job. A really good EMR (or othe…

I wonder if perhaps you work in South Australia, we might be thinking of the same EMR...

Re: Everyone hates the electronic medical record

#18

Post by j16sdiz »

jackvalentine wrote: post #3

Disclaimer - I work for a health service that isn't in the USA and has a very extensive EMR. I don't disagree. I started my career dealing with paper folders of records that were fastidiously organised by a team that made sense of them. Now everything is electronic and fucking _everywhere_. The work didn't go away - but giving everyone a computer made it everyone's problem and nobody's job. A really good EMR (or othe…

Clinic can't organise their file in their own way is a big time waster.

Each clinic have their own speciality and therefore their own way of filing stuffs

Re: Everyone hates the electronic medical record

#19

Post by whatshisface »

wharvle wrote: post #9
jackvalentine wrote: post #3

Disclaimer - I work for a health service that isn't in the USA and has a very extensive EMR. I don't disagree. I started my career dealing with paper folders of records that were fastidiously organised by a team that made sense of them. Now everything is electronic and fucking _everywhere_. The work didn't go away - but giving everyone a computer made it everyone's problem and nobody's job. A really good EMR (or othe…

This is everywhere. We made everyone their own secretary but gave them crappy tools and no training. Also they’re never gonna be doing it more than very part-time, so will always tend to be bad at it and find it a distraction from the work they’re actually good at. I’m skeptical computerization has even been a net benefit for productivity for most jobs , for that and other reasons. I think it’s been such a huge boost…

It's all visibility and no observation.

Re: Everyone hates the electronic medical record

#20

Post by tpmoney »

nradov wrote: post #14
FwarkALark wrote: post #7

Earlier quoted context omitted.

Is this something where a public competitor might help? It surely can't be worse than private industry.

There is (or was) a public competitor. VistA was largely developed by the federal government. Some organizations still use it and it's available for free, but independent reviews have generally rated it as worse than the private industry products. https://worldvista.org/AboutVistA

Interestingly the linked article seems to be singing praises of VistA, though it's unclear whether the author has actually used the system themselves. They link to an unsourced article with that claims it tops reviews, but clicking through to the various related articles seems to have a consistent theme of people not liking VistA all that much.
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