Physicians

KevinMD turns into raving socialist…

Well not quite, but in his op-ed at USA Today Kevin talks about why it’s a problem for the US not to have wide deployment of EMRs, and notes that it’s the wrong incentives that are to blame—docs have to pay but others reap the rewards. So in Kevin’s words:

One needs to look at the Department of Veterans Affairs for an optimal model. All of the VA’s primary care physicians, specialists and hospital-based doctors across the country use the same electronic record system. It has played a significant role in the reduction of medical errors, optimization of cost efficiency, and attainment of high scores in preventive care measures.

Kevin’s usually criticizing me for being the wooly lefty, but I could be pardoned for thinking that he’s suggesting that we junk the current US system in favor of rolling all docs and patients into the VA. I wouldn’t suggest that but far be it from me to tell Kev that he’s wrong!

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RobMedicoGlobaljdJ BeanMaggie Mahar Recent comment authors
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Rob
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Rob

I’m a technologist. I’ve been implementing information technology professionally for 25 years. I’ve been doing EMRs for the last 5. There are lots of ways this can go wrong, large or small? 1) Resistance: People hate change. Sometimes they’re correct. Most often they’re a self-fulfilling prophesy as, without technologists having support from above, and engaged knowledge from below, we end up the scapegoat. You can’t computerize people. You can only make computers part of their job. Just as you can’t make people fit a paper form. 2) Hyper-acceptance: Problem-solving people with good intent come up with brilliant ideas that ignore… Read more »

MedicoGlobal
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Saving America, one American at a time.
(Kevin is actually very smart, and fair-minded, so probably doesn’t need my help.)

jd
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jd

While Kevin points to the VA, the more pertinent point is that large medical systems generally have implemented EMRs while small, independent practices have not. It’s not a government or socialism thing. That 13% EMR penetration statistic masks a huge disparity between the bulk of physicians in 1-3 person practices and the minority of physicians in large practices (or at hospitals). The EMR problem reflects on a larger problem of fragmentation in the US medical sector that serves no purpose for the larger public interest. The Mayo clinic manages to offer some of the highest quality care in the US,… Read more »

J Bean
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J Bean

Absolutely. Unless EMRs can be implemented so that we can communicate between practices (and legal issues such as HIPAA can be resolved), there isn’t much upside to using them. There is a very significant cost, though.

Maggie Mahar
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I’d like to take partial credit for helping to convert
Kevin (who is a reader).
Saving America, one American at a time.
(Kevin is actually very smart, and fair-minded, so probably doesn’t need my help.)

Deron S.
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If we are going to coordinate care the way care needs to be coordinated, we either need to all use the same EMR system or we need to have standards that allow the disparate systems to talk. I’m concerned that there has already been a lot of investment before we’ve really had the chance to develop the right standards.
Regarding the funding of EMR systems, there are a lot of insurance companies stepping up to the plate and sharing in the cost with providers. Medicare is also going to offer a bonus to providers that purchase an eRx system.