tag:blogger.com,1999:blog-6076839327674215825.post5244311516666778797..comments2024-03-27T05:14:34.288-04:00Comments on Medinnovation And Health Reform: Physician Culture - Observations after Three Private Doctor VisitsRichard L. Reece, MDhttp://www.blogger.com/profile/03446550629857699574noreply@blogger.comBlogger2125tag:blogger.com,1999:blog-6076839327674215825.post-19536881073720017882009-07-11T23:22:22.518-04:002009-07-11T23:22:22.518-04:00This is an important observation. You have put you...This is an important observation. You have put your finger on the biggest obstacle of all to reform, embedded resistance to change. REALLY embedded.<br /><br />Tonight I took a dvd back to the "Red Box" for one of my children. (http://www.redbox.com/)<br />These places rent dvd movies for a dollar a day. They are state of the art vending machines that only take credit cards. Video rental places are now officially obsolete. The technology is breathtaking. Blockbuster and Hollywood Video rentals will remain for a few more years, along with the growing number of rental stations in grocery stores and other locations. But the handwriting is on the wall. Theirs is a vanishing species. <br /><br />In my post-post-retirement life I work as a caregiver for (other) seniors. One of my assignments was in a skilled nursing facility where I saw a CNA operate a touch screen console during her shift. She was moving through the screen prompts like a kid with a video game. In a few minutes she documented enough information about five or six residents that would print out to at least a page or two each. It's not likely that much of what she entered will ever be printed or retrieved, but I can assure you that if any disgruntled family member or reward-seeking lawyer wants to bring any complaints to that facility they better have all their ducks in a row because the record I saw being created will be air-tight. (And in the unlikely event that a physician actually wants to know anything, the information will be easy to access, plainly presented and dated.) <br /><br />These two examples illustrate a sad but real challenge. Technology is here, like it or not, and the future will be built on that technology. There will be fits and starts and unintended consequences along the way. It may be necessary to rear, train and employ an entire new generation of physicians who "get it." But it is going to happen, with or without the approval or acceptance of those standing in the way. <br /><br />There is a message from the military here for those who cannot see the future: Lead, follow or get out of the way.<br /><br />Not to put too fine a point on it, but health cared as it stands is no coherent system at all. It presents wildly uneven outcomes, costs and disparity of access. For millions of Americans all the fits, starts and unintended consequences imaginable cannot be any worse than staying the course.Johnhttps://www.blogger.com/profile/11858939352263715787noreply@blogger.comtag:blogger.com,1999:blog-6076839327674215825.post-72548463551567094822009-07-11T18:31:57.153-04:002009-07-11T18:31:57.153-04:00It's disheartening, though not surprising to h...It's disheartening, though not surprising to hear that some specialists' hold negative views of EMRs, since so much of providers' collective experience with EMRs is derived from their travails with legacy, client-server based systems. This technology was developed in the 80s and 90s and is not particularly well-suited to fast-paced specialty care.<br /><br />Practice Fusion (www.practicefusion.com) offers a Web-based EMR to physicians for FREE. We are growing rapidly and thousands of specialists are using our system.<br /><br />In fact, physicians who sign up are often charting the very same day. <br /><br />Now that EMR technology has advanced to a point where it can meet the needs of busy physicians,it is our hope that more and more of them will agree that the technology can now begin to fulfill its potential as a quality-improving, cost-reducing, productivity-enhancing tool. <br /><br />That is what President Obama and his staff believes, and that is what we believe as well.<br /><br />Glenn Laffel, MD, PhD.<br />Sr. VP Clinical Affairs<br />Practice Fusion<br />Free, Web-based EMRGlenn Laffel, MD, PhDhttps://www.blogger.com/profile/05860076245385623275noreply@blogger.com