ED Physician Executive Slams EHRs
Tom even cites a January 2014 study that 40 percent of healthcare dollars spent do nothing to improve patient lives. "Why do people do these types of things? Well, because we're risk-averse, it's a rare event, costs are transferable to the patient, so we practice for the exception. We do a bunch of unnecessary testing. [And] there's a lot of unnecessary documentation that goes along with it."
Yet, particularly in the ED, even if doctors have medical records in front of them, they are not going to pore through them when they can just query the patient and get what they need much more quickly, Tom says.
Billable Hours is Not the Model
He contrasts physicians, who get paid more if they see more patients, to attorneys, who bill for the time they spend in any kind of documentation. The more they document the more they can bill. "It's just the opposite for us," he said. "The more time we spend documenting, the less we get paid."
For a significant majority of patients, physicians have no need to spend any significant amounts of time in the medical record. Only relatively few complex patients require such scrutiny, Tom says.
In Tom's ideal world, medical records would be completely mobile and have significant voice recognition capabilities. In a hypothetical scenario, a patient presenting with chest pains would prompt the emergency physician to request a standard chest pain macro, enter appropriate variations, be notified of EKG results, and send those results to the on-call cardiologist.
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