Hosted EHR outage
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My clinic finds itself in a slightly odd setup (at least that's what the boss tells me). We have an Ambulatory Surgery Center (ASC) that is wholly owned and only used by our own physicians, no outsiders.
In the realm of ASCs as far as AAAHC is concerned ASCs are typically self standing entities where physicians come and go as needed, but are not owned by a single clinic. As such the AAAHC requires that all ASCs have their own independent charts that are separate from any the physicians maintain at their private clinics, the same way hospitals typically work (or at least used to). Our physicians are frustrated by this requirement that they are suppose to basically pay for two charting programs when there is never an outside providers involved.
Furthermore, being a specialty office, we have yet to see an EHR (other than million dollar plus) that supports our requirements without extensive tweaking and setup (and really I'm wrong, the million dollar plus ones simply give you the options you require/desire to setup the EHR, where the cheap ones don't so your left creating workarounds that are rarely what you really want), even worse, from our experience, no one has a good solution for surgical medicine, or anesthesia (all the local hospitals chart to paper in the OR, then scan those documents in as PDFs).
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We find ourselves way ahead of the curve when it comes to use of the EHR. When we decided to go forward with an EHR, we went full tilt. No more paper charting (but I found out later that wasn't entirely true as our anesthesiologist does chart to paper - I guess it takes to long to type in the type and type of meds being give as fast as they are, etc).
We did it pretty successfully too in our first EHR Clinician from Bond Medical, which was bought by Medinotes, who then merged with Allscripts where ultimately our product was EOL'ed in favor of Allscripts current product. Unfortunately the support provided by Allscripts was so poor that we pretty much wrote them off immediately as a viable alternative to move to.
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Ironically small one doctor practices have complained that EHRs are not setup for the way they run their practice. Too hard to too much time needed to make it as easy a using a paper chart. The disturbing part was the argument that 50% of what the EHR was supposed to document is not normally done by the doctors, so why should they have to change the way to do business.
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I wonder if that means that doctors don't document enough or of there is a need for EHRs targeted at small doctors' offices.
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From what I can tell, drs are now required to document a lot more than they used to.
Also, drs used to walk out of a room and rattle off a list of things to do to the nurses, now the doc is responsible to put those orders in the system themselves. I figure this is to ensure the proper orders entered, and If wrong, the only one to blame is the doc.
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@Dashrender said:
From what I can tell, drs are now required to document a lot more than they used to.
Also, drs used to walk out of a room and rattle off a list of things to do to the nurses, now the doc is responsible to put those orders in the system themselves. I figure this is to ensure the proper orders entered, and If wrong, the only one to blame is the doc.
Yes, I did a lot of EHR studies in my graduate studies and a ton of that stuff is to correct mistakes and shortcomings of the past. Doctors have developers quite a reputation for not being that concerned with good documentation of clients. Things that IT pros care about pretty commonly for computers, doctors often don't care about with humans.
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A doctor was reading what was required of him for documentation and basically said that it was too much information to give and he should decide what is necessary to document. I also heard office staff whine that they would actually have to provide vital signs for visits.
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My specialty drs don't feel its their responsibility to talk to patients who are fat about their weight problem, that is the internist job.
Said goes for vitals, etc.
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@Dashrender said:
My specialty drs don't feel its their responsibility to talk to patients who are fat about their weight problem, that is the internist job.
Said goes for vitals, etc.
This is why the US lags the rest of the world in healthcare. In the southwest, people cross the border into Mexico to get better healthcare out of pocket!!
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@technobabble said:
A doctor was reading what was required of him for documentation and basically said that it was too much information to give and he should decide what is necessary to document. I also heard office staff whine that they would actually have to provide vital signs for visits.
Imagine if IT pros said that about keeping baseline information on systems. Just shows the horrifically low standard that we set for doctors here. It's no wonder no one trusts them. If they were junior system admins, they'd be fired. No one needs useless "professionals" who know so little about or care so little about their careers or their charges.
