Modern electronic medical record technology

gibby2015June 12, 2014

I had a screening mammogram today at 3:45 at a breast center about 15 miles from my internist. At 5:15 I got an email notice that I had a new message on the MyChart app on my phone. MyChart is the patient access to the electronic medical record. It was a message from my internist with test results - mammogram was negative. Wow - I was amazed at the efficiency of this. I don't have a lot of anxiety about mammograms but if you did, how nice to get the results before you even get home. I like computers and technology and very happy that healthcare facilities are finally moving beyond the paper charts. It makes it possible to do all these cool things with technology.

Are your healthcare providers pretty progressive with technology?

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Some are and some aren't. It depends on how much they want to invest in their business and how comfortable they are with various forms of technology.

    Bookmark   June 12, 2014 at 9:21PM
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Electronic records are going to be mandatory in medical offices soon. They are not mandatory in my allied health field but three of the four facilities I work in are all digital.

    Bookmark   June 12, 2014 at 9:25PM
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tishtoshnm Zone 6/NM

I have mixed emotions on the EMRs as I currently work in medical transcription and see my job going the way of the telephone operator. I do of course recognize the benefits of finding the information, quickly, etc. Less thrilled with the doctor trying to put information into the chart during patient visits though.

    Bookmark   June 12, 2014 at 9:29PM
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Annie Deighnaugh

Yes, but I'd rather a doc type it in and have it legible than the handwritten scrawls that only the best decipherers could understand...

    Bookmark   June 13, 2014 at 8:06AM
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I agree that it is annoying to have the doc typing away (or cursing as things don't go well) than paying attention to me. I swear I am going to jump off the exam table and help them one day. "Here, you examine me and I will type it in". My ophthalmologist has a transcriptionist (scribe) that follows him around. What a boring job! I wouldn't want an extra person in the room for any other kind of exam.

However, it is amazing what the docs can pull up and see quickly, but lie anything that is computerized, you lose the flexibility and the personal touch.

    Bookmark   June 13, 2014 at 9:12AM
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I don't mind the emails, but I HATE the new mandated computers the doctors have to have! It's part of Obamacare.

I have two experiences with it. My long time doctor passed away in January. I got sick and had to find a new doctor. Went to the one who had the best reviews from talking to people. ALL HE DID was sit and look at his computer while talking to me. Uh, hello? Over here! Over here! :)

I had to go back for a follow-up...same thing. Plus, he didn't even remember me!!

Gone is the personal care I used to get. A friend in the medical profession tells me this is the norm now.

Unless I'm seriously ill, put the dam* computer away! lol

    Bookmark   June 13, 2014 at 10:51AM
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I can't begin to express how thankful I am that our drs use advanced technology! The big city we are near has a teaching hospital (with an advanced trauma center) so maybe that has something to do with it. My GYN has a similar method of getting info to patients - called a patient portal. Used online, but you don't have to use that if you don' t want. She has a tablet that she only types on at the end of our visit. My internist does not use a computer in the room, it is input after the visit. Even our dentist uses updated technology. I love it. I feel strongly about finding the best dr/medical care you can. Our internist is wonderful. A few years ago he moved to a new office that is really not convenient to us - no matter. I will follow him further if necessary! Wonderful care, he takes time, talks to us and is very proactive. Does not quickly prescribe meds but searches for the root of the problem - which is my own preference too. I have a friend who dates a scribe.

I've noticed my MIL's oncologist office is the same - no computer in the patient room, they are located outside exam rooms and physician immediately inputs data after seeing patient.


    Bookmark   June 13, 2014 at 11:35AM
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The push for electronic records predates Obama. It is related to the Health Information Portability and Accountability Act, which to me codifies that you have to authorize the exchange of healthcare information between different healthcare providers you see, and a parent or spouse probably does not have access to information without written consent (including the Confirmation of Appointments left my message, if you want to get technical) while any clerk who works for an insurance company has access to anything they want.

The Deadline for conversion to electronic records in medical practice is the end of 2014 or in 2015 (unclear) and if you are Not converted to electronic records you will essentially be "fined" by reduction in reimbursements. So if your Drs' office is Not up an running with electronic records now, they'd better get on the stick: they're running out of time.

This post was edited by palimpsest on Fri, Jun 13, 14 at 18:02

    Bookmark   June 13, 2014 at 5:47PM
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I accompanied a friend to his doctor to be his note taker/advocate. As the nurse is asking him questions, I can see the computer screen and it is the revolting shade of highlighter greenish yellow. The whole screen. I said "wow, how can you look at that? It's awful." She replies she doesn't like it but the doctor does so that's the way it has to be.

Next the surgeon comes in and as he's using the same screen I say "you prefer that the screen looks way?" He says no but I'm not allowed to change it.

Teeheehee, I think someone needs to call the IT department and get that fixed but everyone is assuming someone else wants it that way.

When I left my hosptial job in 2002, they were gearing up to switch to electronic records so it started years ago.

If the staff pays more attention to the screen than to the patient, then the patient needs to say I need you to acknowledge me by looking at me and not just the computer.

    Bookmark   June 13, 2014 at 6:22PM
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DH is a family practice physician and was one of the first docs in the state to go to electronic medical records. This was years ago. It is a love/hate relationship still. The server goes down. The internet freezes or knocks them off. Someone drops their PC notebook and it needs to be fixed quickly so as not to get behind. But, I agree that it does have many good points as well. I still have a hard time reading my DH's handwriting! I also agree that docs need to keep their PCs out of the exam room. Mine does, but I know many docs who rely too heavily on them while in the exam room with a patient.
Good topic!

    Bookmark   June 13, 2014 at 7:53PM
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I'm a Medical Records clerk part time in a Community Health Center. We have electronic records and are switching to a new EMR this month.

I can't imagine doing my job in paper. We probably do 5-10 Social Security requests a week. Some of them are over 100 pages. I think handwritten notes might not be as long. But they also might not be as detailed. Lots of our funding is federal, so we can track certain data to report easily. (well, as easily as we can get the providers to fill out their billing sheets correctly) It also aids when we are looking for grants, etc.

We had a provider leave the practice recently. They estimated that 400 patients would follow her to her new practice. Some of her patients have been with her since the beginning and are insisting on bringing their "entire medical record" with them. I'd say her average patient takes about 10-15 minutes to electronically gather the record and send via fax. If it was paper and we had to rely on our horrible copier? It would be weeks!

We "go live" with a new EMR July 23. It's been quite the process, but I think the new system will be great. I think it will be a long while before we figure out all of the bugs, and the best way to get our tasks done. For some reason that stuff doesn't seem to be covered in the training.

I saw my PCP this morning. Nothing is electronic. There's a lot of shuffling and moving of paper, but it all works just fine. I saw a Rheumatologist once who spent the whole time looking at the screen. She was very awkward and sort of rude to boot, but her consults are always in our office that day or the next!

Beth P.

    Bookmark   June 13, 2014 at 9:11PM
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What is the point of having the computer outside the exam room? That's where the patients records are. If the physician wants to pull up lab work or some other study it's right there.

I had a colonoscopy last week and yesterday I had a follow up with my internist. As part of our discussion I mentioned that two medical assistants at the Gastroenterologist's office asked me several times if I had ever had a stress test. So I asked him if I should get one.

He pulled up the ECHO and the EKG that were done 2 years ago - before I even started going to this physician. Then he said I didn't need a stress test - my blood pressure is normal, my cardiac studies were fine, my lab work good, and my physical exam was good and I don't have any symptoms. He did say that if I were planning on starting some rigorous training program then I should have one.

It was very quick and simple having the computer right there.

    Bookmark   June 13, 2014 at 10:36PM
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Elraes Miller

My DD's ortho never has a computer in the room. There is a long bank of cubbies in the hall between patient's rooms. He sits down there when we are leaving.

Mine is in the patients room and always typing while I'm there. It really bugs me that I can't see what is being entered, but do go home with a printout of the appt. Sometimes I don't want to intrude while typing and feel like I lose personal time.

They just sent a Gov. letter a about having access to all doctors seen...or not. It is up to the patient. Their answer to this was doctor shopping for pills.

Lynn, do you know anything about this? If a patient were to say no, would a physician not prescribe narcotics? Or keep them as a patient?

    Bookmark   June 14, 2014 at 4:32AM
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Technicolor - maybe I misunderstood your question - but you have the right to refuse any treatment - it may not be in your best interest to do so - but it is your right and a good opportunity to have a frank discussion with your physician.

    Bookmark   June 14, 2014 at 7:50AM
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My SO's orthopedic doc uses a hand-held tablet that he can hand-print his observations on, then it sends to the chart files.

As for one doctor being able to "see" how many other doctors the patient is seeing and for what, that would have SERIOUSLY improved the SO's mom's health care. It wasn't a case of "pill shopping" ... she had mild dementia and would visit several doctors for the same problem instead of sticking to one.

The health insurance company did not spot it, but if the THREE back specialists, two cardiologists, and a few others she was seeing had been able to see that she was getting meds from all of them they could have consolidated the records and put her care under a single practice, so the drugs were interacting, cancelling each other out, and in general not working well.

She NEVER TOLD them about each other, or the prescriptions she was getting. The pharmacies spotted it, but at that time, could not LEGALLY notify anyone because they weren't narcotics.

    Bookmark   June 14, 2014 at 8:56AM
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My doctors all have a computer in the room. It's never bothered me. They use it to review my history with me and really doesn't seem any different than flipping through a chart to do so other than much more thorough and systematic. They must document the visit after they leave the room as they never go back to the computer after the exam. One of my specialists isn't part of the major health system I normally go to so she has a different EMR. I kind of don't like that because all my stuff isn't accessible to me in one place.

Even my husband who doesn't love technology as much as I do uses the patient app to schedule appts and send messages to his docs if needed. I really like being able to send an electronic message for something simple rather than trying to connect by phone. My internist who is in her 50s seems to have adjusted well to the technology. My husbands doc who is older hates all the changes and is retiring - a good thing in my opinion.

This post was edited by gibby3000 on Sun, Jun 15, 14 at 9:34

    Bookmark   June 14, 2014 at 10:21AM
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I think it's the difference in doctors. I have no problem with electronic records. What I do have a problem with is the doctor spending 90% of his time looking at the computer and not at me. No wonder he didn't remember me a few weeks later. Cold. And his computer was large too, and on a stand.

I feel he was snooping through 33 years of medical records from my deceased doctor. What I had was a common illness that needed antibiotics. Period. And what he should have done was go through my records, especially medicines I take which I hand delivered a list of them, *before* he saw me.

There was absolutely no need to look at the computer while I was there. None. He has no people skills and the computer makes it easy for him. He hardly spoke to me, but when he left the room he immediately started laughing and joking around with his staff.

A friend went to him also, same thing. Unfortunately, there aren't that many doctors in my area unless I want to drive 30 minutes to one, and if I'm pretty sick, that's not happening. lol

    Bookmark   June 14, 2014 at 11:01AM
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marie cate - I think the dr not having the computer in the room is out of respect for the patient. I get his full attention. When I have a physical, lab work is done usually two weeks before. My dr has all results (and any other testing, etc.) printed out before he sees me. He has reviewed them and gives me a copy to take home. If, like in your example, I had something done by another dr., he could simply go outside the room and pull up the record - the computers are nearby. More than likely as my PCP, he would know what I had done and would already have the results. I love the use of technology, but I also appreciate my dr's attention when I am in the exam room.


    Bookmark   June 14, 2014 at 11:01AM
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Elraes Miller

Marie, I opted to have records available from other doctors, which is the same as going to lab access. The question was about others who opt out. My PA explained that the program had many uses, quick access to my full info from other specialists seen. But also to restrain doc shopping and knowing meds prescribed. An example is a med I take that she prescribes because I am tired of going to the neuro too just to get a refill..needs to be hand carried. I could get this med from both if she did not have info on my seeing him or others. Which I wouldn't. The question was what ramifications occur to those who do abuse this..

    Bookmark   June 15, 2014 at 9:02AM
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I don't get paper copies of results to take home. Instead, I log on to a secure website and see everything...from my test results, doc notes , account, to status of insurance claims. No more medical paper in this house.

    Bookmark   June 15, 2014 at 9:15AM
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"They use it to review my history with me and really doesn't seem any different than flipping through a chart to do"

My optometrist has EVERYTHING on computer (his exam machine is computer controlled), and showed me the eye scans.

The SO's ortho doc often shows people their x-rays and explains what is going on and what it means for treating the condition, if there is something beyond "see this bone, it's broken right here".

    Bookmark   June 15, 2014 at 9:42AM
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I feel he was snooping through 33 years of medical records from my deceased doctor.

Reviewing a new patient's medical history is not "snooping". I can understand not being comfortable with a new doctor, but it is important for your doctor to know your medical history.

    Bookmark   June 15, 2014 at 12:16PM
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