When is medical information avaiable to your Dr?

marie_ndcalMarch 3, 2013

Clarification: Trinity here in Minot put in an extensive computer system about 2 years ago that all your information is put into. That is any medical person in the Trinity system in the entire state has access to that information.
Most people like it because if I am in another town, and they have a Trinity medical center, and there are several spread out, all my records are avaiable immediately. Prescriptions, lab work, etc. It has saved people from having extra lab work and saves time.in case of emergencies.
Any one else have this??

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Electronic medical records have been mandated by Congress for all health care providers who accept federal funds (Medicare, Medicaid etc.) . Providers have been given several years to transition and I think the date for final compliance is sometime in 2015. If you do not comply then your medicare reimbursements will be lowered.

This is a highly expensive venture. The small group (4 doctors) practice where I work part time has spent over $250,000 to get this set up. It meant all new computers and notebooks for just about everyone in the office - physicians, nurses, techs, billing clerks etc.

The price for the proprietary software alone was enormous and since this is a sub-speciality practice there were only 2 to pick from so there was little competition to lower the price. I can't remember how many hours the staff spent in training to learn the new software- which of course came with it's share of bugs that needed to be resolved.

Most of our patients detest the fact that now their doctors spend the initial part of the appointment asking questions and typing in the answers with barely a glance at the patients.

I could go on and on about this but if you want to read more just google Electronic medical Records Deadline or Implementation.

    Bookmark   March 3, 2013 at 3:15PM
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All of our doctors and local hospitals are linked, so our records are available to all. It is very convenient.

    Bookmark   March 3, 2013 at 3:52PM
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Just a note to quilly---you mentioned the doctors spent time asking questions and typing on the computers. At the clinics I go to, the nurse does all this--meaning recording blood pressure, temp, meds, and other information. She/he makes notes that I want to discuss with the Dr. etc. The Dr. does some typing but it is usually after the exam and discussion. I can see with only 4 doctors it would be time consuming. How many nurses does each doc have.? Our center is quite large with offices spread out over a large area with a variety of specialities from family practice, to heart to pain clinics to even eye doctors. the cancer center is included also. We are also lucky to have a excellent supply of not only nurses, but LPN, and asst physicians. We also have a college in the area that sends students to practice. with the doctors.

    Bookmark   March 3, 2013 at 10:15PM
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Marie - perhaps clinics operate differently than a private practice. Is there one central check- in where the nurses at the clinic record the initial information for all the patients regardless of which medical specialist the patient was going to see?

Our office has 4 oncologists - we had 5, but one retired and her replacement will arrive in July, two Physician Assistant's, 8 oncology nurses, and then an assortment of techs, LPNs, clerks etc.

Nursing assts. or techs do take the initial check in, - height, weight, BP etc. but the physician does the rest. A new cancer patient has a 50 minute appointment and the doctor probably spends 15 to 20 minutes asking questions about the patient's symptoms etc. and then does the exam.

But it isn't just our office that operates that way. All of the physicians that I see have a similar routine - my Internist, my OB/Gyn, my rheumatologist, my Dad's cardiologist and his nephrologist.

We have 5 medical schools in town so there's often a student doing a clinical rotation in the office. It seems like this might be the difference between a private practice and a centralized clinic.

    Bookmark   March 4, 2013 at 6:54AM
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I love electronic records. In my doctors' offices, whoever I see first does most of the typing. I don't find it onerous - before this, they were writing the same things, so it's not like they were sitting eye-to-eye with me then, either.

I do find some of the questions repetitive, but I also think they're useful. For example, by going over my prescriptions every time, I've realized that I didn't always mention to my doctors when I started taking a new OTC medication or finished with a prescription. And by going over symptoms every time, my doctor is able to monitor changes better than if s/he just relied on me to report changes.

The thing I love most about the electronic system is that it allows me to email my doctor. I already had my internist's email address, but now I can email everyone - and I do, when I have any issue. I can use the system to ask for prescription refills, to make sure all my doctors see something when it's important, etc.

And I love being able to see my test results immediately.

All in all, an excellent change for the better.

    Bookmark   March 4, 2013 at 7:44AM
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I love the transition to electronic medical records.

When I get my lab work prior to a Dr. visit....The lab also sends me the results. Also, I can go to the lab the day before a visit, and the Dr. has the results the next day.
Same with scans....I go to the hospital for a scan, and walk out with a CD of the scan, and the doctor also gets the result within 24 hours.

When I have a Dr visit, he records on his laptop any lab requests, and next visit....and when I leave the receptionist has them all printed out and gives them to me.

    Bookmark   March 4, 2013 at 7:53AM
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Thanks for clarifing your doctors offices and they may have a different software program. I am asuming there is several ones out there. I think with ours, there was alot of in office contributions because I know the CEO did work with the computer company in setting it up.

    Bookmark   March 4, 2013 at 11:03AM
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Most of our patients detest the fact that now their doctors spend the initial part of the appointment asking questions and typing in the answers with barely a glance at the patients......
A new cancer patient has a 50 minute appointment and the doctor probably spends 15 to 20 minutes asking questions about the patient's symptoms etc. and then does the exam.
Curious what the dr's did before they went digital? Did they (dr's) ask the same Q's & write/record the answers in the paper medical record? A lot of times new pt's have to fill out questionnaires that ask these same Q's. Seems that this could still be done & simply have the data entered by a clerical staff person. Then the dr can spend more time focusing on the patients problems. 15-20 minutes of the dr's time entering data much of which might be superfluous doesn't seem to be efficient use of his skills/time.
I wonder if part of the problem with the pt's being put off by the dr's asking & entering data is the fact that the dr's barely glance at the pt... i.e. it feels robotic... and, as well, some people's aversion to "new age technology". With a cancer diagnosis you want to feel like a "person" & you want a dr who exudes a "caring attitude". I could see how that isn't the first impression given in the scenario you describe, Quilly. Hopefully drs & pts as well will grow more comfortable with the electronic med. record.

When my dh recently had serious medical issues the Q's were not ask/entered by the dr. Other staff took care of that. Then when the dr came into the exam room, he looked over the pertinent data & proceeded from there. He entered some data himself following the exam, ordered tests, & sent off a script to our pharmacy. Then a summary of the visit is printed off for the pt.

I love the electronic medical record. Love being able to see my lab results before going to dr, then I know how to focus my questions. My dr's office is fully engaged. Some dr's have had a bit of a learning curve & weren't so computer savy. But I think it's time to get with the 21st century.

    Bookmark   March 4, 2013 at 11:33AM
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The end goal is to save time and prevent mistakes. A probably unintended consequence has been that costs to implement this are so expensive that small medical practices have folded. Hospital chains have been gobbling up private MD's and labs -- and smaller hospitals -- since this was mandated. (I hate THAT part!)

    Bookmark   March 4, 2013 at 3:48PM
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I wish there was one national database were copies of all your medical bills and chart notes were stored. It would save me tons of paperwork sending requests and releases to dozens of providers. It would also help me find out when clients are being less than forthcoming with us about prior treatment, prior accidents, etc., before we get so far into a case we can't get out of it and it's too late to find out the client has had five prior back surgeries, has filed five previous personal injury claims, stuff like that.

    Bookmark   March 4, 2013 at 4:19PM
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angelaid--I too wish that had some sort of national set up, but I can also see problems with releasing too much information. Like you said it would save time especially with the people that bounce from DR to DR for meds or other work. But insurance companies get the results too, and SOME, not all companies would either deny payments, or drop the coverage. Also some medical personal could get information they are really not entitled to, and these could be relatives. There would have to be some safeguards.

    Bookmark   March 4, 2013 at 9:16PM
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Agreed, Marie!

    Bookmark   March 4, 2013 at 11:03PM
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