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Everyone hates the electronic medical record

logicmag.io

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Re: Everyone hates the electronic medical record

#41

Post by consp »

perilunar wrote: post #23

I spent two hours this morning helping my elderly mother fill in a hospital admission form online. The session timed out just before submission, but we logged in again and everything was saved. I'm grateful that it was online, so I could help her remotely via screen sharing and not have to travel to fill in forms (I'll visit when she goes in, just don't want to have to travel repeatedly for paperwork.) Entering medic…

> Entering medical history and current medications was a pain in the arse though, and is something we have done many, many times over the last few years.

Isn't this something what electronic records should have solved? I know doctors always ask the patient but they all have access to that data here (not us). Especially the pharmacy looks at it to check for cross interactions (or a note waiving them).

Re: Everyone hates the electronic medical record

#42

Post by morsch »

perilunar wrote: post #23

I spent two hours this morning helping my elderly mother fill in a hospital admission form online. The session timed out just before submission, but we logged in again and everything was saved. I'm grateful that it was online, so I could help her remotely via screen sharing and not have to travel to fill in forms (I'll visit when she goes in, just don't want to have to travel repeatedly for paperwork.) Entering medic…

> just implement an standard text format

Standards and protocols would go a long way in solving many of the issues in public IT infra. Force the big players to speak them. Enable the small shops to outcompete them (and each other) by sucking less in one area.

Re: Everyone hates the electronic medical record

#43

Post by FirebornX »

mr_toad wrote: post #21
nradov wrote: post #14

Earlier quoted context omitted.

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

I have to wonder how independent those reviews are when medical staff consistently rate it higher than commercial products, the system has won multiple awards, and when the VA tried to implement a commercial replacement it failed. Vista is public domain, so there’s no money in it and no-one to take management out for expensive lunches.

People generally like VistA a lot more than what the DoD has been pushing the VA to replace it with: EHRM.

https://www.gao.gov/products/gao-23-106685

https://www.moaa.org/content/publications-and-media/news-art...

Re: Everyone hates the electronic medical record

#44

Post by oldgradstudent »

When my Israeli health care provider switched to electronic records in the mid-late 1990s, a typical medical appointment had two parts, roughly similar in length.

During the first part, the doctor would complain about how the system crashes, how hard is it to type with two fingers, and how computers are pointless. In the second part, I’d complain about my flu/cold symptoms.

Re: Everyone hates the electronic medical record

#45

Post by someonehere »

As a patient it benefitted me a month ago.

I was looking to get Ozempic through a different medical provider. They were offering a discount at the end of 2023 before rates go up in 2024. So in a rush before the end of 2023 I was able to log into One Medical and get a copy of my lab work and medical records from them within 10 minutes. Sign into my account and export the records and lab work and send them to my new provider.

I was impressed I didn’t have to jump through a ton of hoops to get the info I need to get the medicine.

Re: Everyone hates the electronic medical record

#46

Post by repeekad »

captaincraven wrote: post #31

Disclaimer: Worked at Epic for > 3 years. EHR’s have all the problems of enterprise software, plus some. At the end of the day, the software is made for the people who pay for it. This isn’t the patients, or the providers. It’s the admin, billing, and bureaucracy layer who get to make all the decisions. It’s not surprising that these people don’t prioritize good software. EMR’s need to do more, but the root of the pr…

Also, even if Epic offered its platform free of charge, it’s incredibly expensive to setup and train staff. Just that initial expense of plugging everything in is a huge risk that many hospitals on a tight budget likely can’t afford to take.

Re: Everyone hates the electronic medical record

#47

Post by rkagerer »

analog31 wrote: post #2

My mom would just bring a briefcase full of printed medical records to every appointment.

You may jest but I wouldn't mind this model. i.e. Records are under a digital lock to which I hold the key, and can grant access to a medical professional service provider for a period of time with set access expiry.

Written records at least provided some physical locality that made me feel less at risk, and it was also easy for me to ask for a photocopy for my own records (I'm surprised how many people just entrust this to their institutions).

Re: Everyone hates the electronic medical record

#48

Post by m463 »

I wonder if it can just be a market. Standardize the data format and install apps that manipulate it.

Let pediatricians choose one editor, surgeons another, nurses another, etc...

Maybe the surgeon's app is text to speech. The pediatrician hooks into his stethoscope.

Re: Everyone hates the electronic medical record

#49

Post by duffpkg »

I created the ClearHealth/HealthCloud open source (GPL) EMR which to my knowledge is the only open source one to receive full federal certification. Operations (not surgery) are so incredibly bad / incompetent in most healthcare settings that software frequently gets the blame for much deeper problems. This article is a doctors perspective on how software did not fix a completely broken workflow. I don't begrudge him that but there is no software in the world that can ever address those types of problems. In my experience doctors are a tremendous barrier to resolving problems in healthcare operations, they are chasing their own incentives that are in some ways opposed from those of the patient just like the insurers are. It is very tortured process to institute proper operations in a medical setting, I spent most of my career doing it, no one complains about the software when operations make sense to begin with. In-N-Out instead of McDonalds, is something that should be incredibly aspirational to healthcare as an industry but doctors tend to despise the comparison.
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