Chester County Medicine Winter 2020 - 7

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when asked to change a seemingly simple feature is, "We can't do
that.". And when asked, "Why not?", the answer is "Because."
The because is because the EMR vendors are, in effect, virtual
monopolies. They do not have to compete for our business once
a system is chosen, as they know the cost and time involved in
converting to a new system is prohibitive.
EMRs, as originally conceived, have enormous potential
to improve medical care. As Osler noted, "90% of making the
diagnosis is the history." Immediate access to X-rays, blood tests,
consults, discharge summaries, vaccination history, etc., would be
a dream come true for physicians and all health care providers.
So what is the point of my essay? It is to prompt all of us
to help advance the process to converting the "EMR - the great
lie" to "EMR- the fabulous tool." You and I are not naïve, as we
both know the real change must come from our state and federal
legislatures to correct the fundamental legal guidelines needed for
the overhaul, such as insuring interoperability of EMR systems
and removing "meaningful use" mandates.
I would recommend anyone even remotely interested
in this topic to read Robert Wachter's The Digital Doctor, or at
least the first 2 chapters. Moreover, I urge everyone, physicians
and patients, to address the fundamental problems of electronic
medical systems, by calling your State and Federal Representative
and asking two questions: Why are EMR systems so poor as to
be causing half the physicians in the U. S. to consider retiring?
Why are EMR systems not interoperable? After all it was the
HITECH bill passed in 2009 that essentially forced electronic
medical "records" on the medical community. These systems were
and are developed for accounting, billing and "data collection,"
not patient-physician clinical interactions. As a result, our
existing systems are good for the government and insurance
companies, but not the patient and physician. Unless our EMR
systems become interoperable and the Meaningful Use mandates
are removed we will continue down the road of medical record
perdition.
Summing-up
If EMR systems had been given the opportunity to evolve
organically, the amazing electronic hardware and software that
would be available now would truly make medical care better and
cheaper.
To contact Dr. Colley send email to:
bacolley828@gmail.com
WINTER 2020 | CHESTER COUNT Y Medicine 7
http://www.chestercms.org http://canopybiomedical.com
Chester County Medicine Winter 2020

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