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Posts tagged ‘medical records’

Why I really like electronic medical records

As a physician, I am not supposed to like electronic records. Or at least it seems that way. That doesn’t mean that I think that the is one ideal system. There is not one that’s perfect, but I think overall they are a good thing. I know regulations are forcing them on the providers and there is a natural resistance to that, but I believe that the market would eventually switch to electronic health charts. It would be a slower process and would probably be easier, but it would happen.

Why you ask. That is say, doctors graduating from medical school grew up with computers in their home from birth. While I am old enough to remember the Apple2 and riding with my dad to take a pile of punch cards to a mainframe there are those now graduating who never heard of such a thing. They grew up with a personal computer in there home and Internet. Probably dial up for the current class, but there are high school students who would not believe that someone would use dial up

But as to why I like them… Do they make me a better doctor? As far as diagnostic skills, no. Computers don’t improve bedside manner, and in many cases hinders it. At least in some cases, especially during the install or conversions. But it does help with drug interactions, it helps remind that the patient is due for certain steps, and everything is there. And it is legible.

That is probably the best thing. I have specialists that have terrible hand writing. I get a report or a copy of their visit note and I cannot read it. So despite having their notes, it doesn’t help since I cannot read it and still have no idea what it is.

It also has helped with coding. Since converting I am coding visits higher than I ever did by hand. While you still have to look at what the codes say, because I am responsible for whatever I code or the computer does, it has been accurate and for the most part increased my reimbursement. My software includes everything, scheduling, billing, chart notes, so once I sign off, it gets billed and sent off to a clearing house and then to the insurance companies. I don’t have to fumble through charts, cause it is all threat my fingertips.

I have a system that reminds me to look for test results, consults and other items after it has been too long. So the reminds in itself is nice

As for the theory that patients don’t like their doctor turned around typing with their back towards them,well I wouldn’t either. I have tablet, that at one point had a pen, so there was little difference between writing on a chart or writing on a computer tablet. And if I would prefer to type, well I can do that too.

Overall, I think that electronic records are great. There are bugs that need to ironed out, and some of the requirements from CMS are pain to meet, but the concept itself is a winning one. And as technology continues to advance so will these systems, which will help to take better care of patients.


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