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January 24, 2011


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Hope Hetico RN MHA

Why Doctors DO NOT Need eMRs?

As a doctor, it seems as though you’re being told by everyone that you need to jump into electronic health records and electronic medical records software; that’s like telling you that you need to manage patients’ records and is so obvious as to be useless advice.


We need Patient Collaboration Tools instead!

Dr. David Edward Marcinko MBA

L Gordon Moore

I wish we had a great open source document describing the specific needs, but a short list would include:
The ability to securely share data (with patient permission) between all silos of health care.
The ability to automate all the administrative hoops and hurdles insurers use to manage costs (eligibility, benefit nuances, co-payment/deductibles, formularies, prior authorization).
The ability to manage individual and population health data with flexible and reliable reporting engines.


On Paper MRs

Some doctors believe that the idiosyncrasies of hand-written or paper notes do more to convince a courtroom [jury and patient] of their level of involvement than a computerized, cookie cutter, mind-numbingly cloned note or a prompt driven fill-in-the-blank template. Me too!


Why? It is easier to conclude that the doctor was really there; involved, listening and thinking; etc.

IOW: Caring

Dr. David Edward Marcinko MBA CMP™

Robert Watkins

"most elecronic health records are trumped up billing engines"

So true. It is very easy to imagine a usable EMR if it were designed only to improve patient care. However, as long as they have to accomodate CPT/ICD/"coding for dollars" requirements, I'm very pessimistic that they can become more usable. The MU regulations, which are designed primarily to allow data-mining, could well make things worse.

There's a fascinating article in Arch. Int. Med. this month that shows no difference in "quality of care" (as we currently measure it) whether EMRs or paper is used.



your concluding line suggests that you and/or one or more of your colleagues has done a pretty thorough matrixing of capabilities of extant systems. Why not make that analysis available to others to help clarify where the hurdles lie?

When there are open source initiatives that are at least alleging to tackle the performance/cost conundrum you allude to (one humble example - Open MRS: openmrs.org/ ), surely identification of "what doctors really want" in EHR - rather than "what doctors really whine about" - would help provide them a lamp in the darkness?

L Gordon Moore

Ha! My bad.
Thanks for catching the bad link. Should be set now.


you have to admit it's kind of funny that in an article of this type, your link to the "Paging Dr. Luddite" article is malformed, and maybe too that your typepad configuration does not seem to permit html in replies. Maybe there's a fax #...?

Atlantic article link: http://www.theatlantic.com/magazine/archive/2010/12/paging-dr-luddite/8292/

ok, I'm a mean person ;-)

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