How many large businesses can you think of that don’t have their records computerized? Would you be surprised to know that a business with over 2 trillion dollars in revenue is largely not computerized? Welcome to Medicine!
Computerizing medicine is a subject which is important to me. When I left the Huntington Medical Group about 12 years ago, I decided that my new office was going to be paperless. At that time my decision was based on the horrendous nature of paper charts. In a single specialty practice the issue of finding charts is not as daunting as at a large multi-specialty practice, but at my last practice there were times you had to see a patient without their chart because it could not be found. Putting that issue aside, in a “papered” practice, if a patient calls, someone has to pull the chart, take a message, pass the message and chart to the physician, the chart has to go back to the technician for a return call to the patient and then the chart has to be re-filed. In our office, whoever answers the call has the computer at their fingertips, pulls up the patient record and then sends an e-mail message to the physician. Charts are never lost or misplaced! It also eliminates the “chicken scratch” that most physicians call writing. When I get a set of notes from an outside office, its frequently impossible to decipher the writing!
From the computer the physician can review a patient’s entire record including photos and correspondence from other physicians. You can then e-mail or fax a prescription for medication directly to the pharmacy, send a report to a referring physician or print a copy of the report along with an educational article for the patient to take home. That doesn’t even begin to take into account the power of computerized records for doing research and understanding patterns of disease and treatment.
Now the government is mandating physicians computerize their records and are offering incentives to comply and eventually penalties for non-compliance. This sounds wonderful on the face of it, but the government, in its typical governmental fashion, has mandated compliance with “meaningful use”. In fact, we are getting ready to try and comply with “meaningful use 2”. Sadly, much of this is meaningless! Its like jumping through a bunch of hoops to show you can but in fact it has little to no impact on practicing medicine. The offered incentives do not offset the cost of the computerization of a practice and add to the burden medical practices already face to remain compliant. Many older physicians will retire rather than deal with a computer and many in practice will deal with the penalties rather than transform their practice – it would cost them less in dollars and aggravation!
So where is this all going? I believe this measure along with the new healthcare laws will spell the end of private practices. Follow my blogs for more thoughts on this issue and others!