This isn't about the physicians. It's about us. If I live in San Francisco and am in a car accident in Atlanta, physicians at the hospital I'm having surgery at can see my medical history so they don't do something contraindicated and kill or paralyze me simply because they didn't know something about me.

While I hate the fact it may make things difficult or impossible for some doctors, the reality is that we need this.

Unfortunately it is not that simple as pushing a button and being able for a physician in SF to see an patient's records in Atlanta. I am an md with an EMR (electronic medical record) for the last 7 years - and it does not communicate with any other system electronically to deliver medical information - except to fax prescriptions. For patient confidentiality purposes, there are all kinds of firewalls that make it impossible for one system to safely communicate with another system - and there are many different vendors supplying EMRs - which complicates the situation further. Large facilities - Kaiser, the VA, Group Health - may be able to communicate with each other in different states - because they likely all have the same system. But the average doctor in a smaller group or private practice - is still going to have to print up the record and fax it to whomever is asking for it.

At least there will be no illegible handwriting issues.

There are safety benefits to the EMR ( like allergies, easily understood chart notes and past medical history information) - but to be honest - I think it is always going to be more about accounting and doccumenting issues for the payors (insurers and the government).

Hetep and Respect Working Stiff, I can understand why a rich person would vote for Bush and the forty thieves, however, it amazes me that a working stiff or any person in the middle class would vote for anti-vitamin McCain and those who created the "health" care nightmare we Americans face today.

I am a patient in the VA system. The EMR (Electronic medical record) has been standard their for years. I use to sell the concept and the technology decades ago at Digital Equipment corporation.

Any doctor I see has my complete medical history and my latest tests right on his desk. X-ray's, MRI's, blood tests, etc. I know my medical treatment is safer when everyone has the same info and is watching each other. When I go to a different state the same deal.

My question to you is, what person who is interested in their health and health safety would NOT want to have all their docs have all their health information?

While the Dems have given us Health Insurance reform, thank God for the start in the right direction, UHC.

Let me go on the record, The President is creating the most important advance in health care in the history of this country with the EMR.

If you don't think so, name me an advance in medical technology with the potential to help more Americans in the next 5 to 10 years? Better yet, name an alternative to the EMR regarding health efficiency and safety ?

Important seed, Clipped.

Hetep and Respect nwmd, you make the case for National EMR system as well as anyone I have read.

Unfortunately it is not that simple as pushing a button and being able for a physician in SF to see an patient's records in Atlanta. I am an md with an EMR (electronic medical record) for the last 7 years - and it does not communicate with any other system electronically to deliver medical information - except to fax prescriptions.

It is that simple to push a button to access your Master Card in SF or Atlanta because there is a national standard for financial health. That is what the President and the Democrats are putting on place for us people a National standard (called an EMR) that big companies and little small town doc will be compatible with. The docs don't have to worry about the technical stuff we techi types do that. Just like I don't need to be technical to use my master charge.

It is a National disgrace that my financial health can be seen anywhere in the world, but my Physical health can not be seen anywhere in my on Nation.

Bottom line is, Physical Health is more important then financial health, and we need to help the President get this right for us and our fellow citizens. Are you with me on this doc?

Digital medical records have been in the works for years. Long before Obama was around. We used on at our hospital more than 10 years ago. The Fed has been trying to go electronic for a number of years.

Interesting how even electronic medical records becomes political.

Yes Angie, they have been in the works for years. Those practices that can afford it have started moving that way. Between myself and family members I've been to 4 different practices and 3 different hospitals in Kentucky. Only 1 has electronic records and even then they also have a paper backup.

It's the 5 year mandate that is a problem. It alone will force some doctors out of business and cause others to have to join together in big group practices to survive. Those bigger practices will have to be located where the people are, regulating the small rural populations to life (or lack there of) without a local doctor.

This is typical of the short sightedness of this current (and past) administration. Imposing demands without a clear view of the consequences. So yes in part this is also political.

sara-1600751 all those who are paranoid get off the bus. The people after you are on it.

Apparently, you believe that the current administration is out to get us. What's really going on here is that they are trying to improve our quality of care by allowing the physician or surgeon operating on us access to as much medical history as possible.

That's a GOOD thing.

As a nurse, I am grateful to have legible info about my patients

who are unable to remember their exact medications or full list of allergies to medications...

given how complicated the names of meds are nowadays.....

What's sad is that when I walk into a patient room I am spending a lot of time typing and more often than not it is aggravating, disappointing or plain disconcerting for the patients......

Please have patience with us while we learn.

If any of the computer IT persons who have responded to this article know of any positions out there in healthcare software EMR systems...

for a level headed middle aged RN who happens to be fascinated by informatics,

especially teaching informatics to fellow nurses who are frustrated or feel they were born too early in this life to ever feel comfortable with IT technology..... Please contact me.

Point #2 :

FYI Several individuals have been fired from the hospital I work in for even the smallest "unnecessary" accesses to any patient's health info....

We have a "need to know" rule.... which has been widely posted and emphasized in meetings.

If any hospital employee does not have an actual "need to know" reason for looking up lab results or any info whatsoever..........that employee has no right to view the info.

On a yearly basis we must complete "mandatory" review courses on subjects ranging from infection control to fire safety.... Personal Health Info/EMRs/Hippa regulations are right along with them.

I hope that this helps to put some minds to rest at least a to some degree.

Point #3:

I , also, am very concerned about my private info getting into the wrong hands... Already it has

.... thrice now ....I've had to get new credit cards thanks to hackers breaking into the Citibank computer systems and ...

This article was posted on msnbc.... about One of America's largest health insurers problem when their clients info was unprotected for possibly 5 months:

Anthem Blue Cross glitch exposed personal data
SHAYA TAYEFE MOHAJER Associated Press Writer

updated 6/24/2010 8:15:08 PM ET...

About 230,000 Anthem Blue Cross customers have been warned that their personal data, including medical records and Social Security numbers, may have been wrongly accessed following a faulty upgrade of the company's website.

A site user was able to manipulate Web addresses to access confidential information after security measures weren't reinstated properly following an October 2009 upgrade, said Anthem spokeswoman Cynthia Sanders.

"We were told by a third party vendor that all security measures were in place," said Sanders. "As soon as we heard about the attorneys, we went in, discovered the problem and fixed it immediately."

Applicants under age 65 who were applying for individual policies were affected by the breach, said Sanders.

Attorney Dan Robinson, who is representing plaintiffs whose information was in jeopardy, said files were not secured for a five-month period.

"This is one of worst exposures of private information we've seen: medical records, social security, health information," said Robinson.

See it in full online...

our personal info to one degree or another might already be out in cyberspace.....

HEY IDIOT FACT CHECKER...PRES& That's PRESIDENT BUSH (SHOW SOME RESPECT YOU LIBERALS IDIOT!) HE didn't DEMAND it like the SOCIALIST OBAMA AKA HITLER POWER GRABBER, But the good news is this is going to be REPEALED!!! OBAMACARE will not last, it will bankrupt OUR COUNTRY, so this will be REPEALED and most importantly IT'S UNCONSTITUTIONAL! Government is to work for the PEOPLE, not he PEOPLE OWNED BY GOVERNMENT, OBAMA MESSED with the wrong country to try to control every aspect of our lives...he will go down in the history books at the WORST, LET ME REPEAT THE WORST PRESIDENT EVER, THIS GUY CAN'T RUN A DONUT STAND, LOOK AT THE DAMAGE HE HAS DONE IN 18 MONTHS, TO THINK WE ARE GOING OT HAVE THIS IDIOT IN CHIEF FOR 2 MORE YEARS, WELL IT'S A SCARY THOUGHT, BUT THANK GOODNESS NOVEMBER IS COMING WE WILL VOTE OUT HIS CRONIES AND THEN HE WILL BE A LAME DUCK PRESIDENT WE WILL STOP HIS NON-SENSE & TAKE OUR COUNTRY BACK FORM THIS POWER HUNGRY, NARCISSIST CRAZY MAN! Oh another FACT CHECK for your pea-brain, do you remember how the CROOKED LIBERAL, the DEMOCRATS in control of hte house & senate (but not for long, as November is coming & can't come soon enough in my & many other American opinions) how corrupt arm twisting, buying votes with OUR TAX PAYERS MONEY!!! This isn't the way to get legislation through...this obamam-care is a joke, it's obama control, he will fail in the end! It's already happening, had a look at his numbers lately...this guy is a joke! And the laugh is on him!

I know it takes a lot longer to complete the electronic medical records compared to the handwritten version. It also further complicates the custodianship of the database say in those instances when a physician leaves the practice.

When a physician leaves a practice the records stay WITH THE PRACTICE. If you want to stay with a physician who has left, you need to get the records from THE PRACTICE. BTW, I worked in an MD office for 7 years, beginning with the implementation of HIPAA.

I worked with a dental system called axium and it was helpful at times but we were useless without it. Anytime power went out I had to reschedule all my remaining pts.

Mark - have you heard of UPS battery backups?

you must be out of your mind! of course liberalisum is a mental disorder! what about privacy...what happens if everything goes off0line, nothing like good old pen & paper...this is all another obama power grab and to through a lot of business to his partner & crime, ge...that's right. you know the one running the ads we see on t.v... wake up people see this soclist for who he really is...you ar all going to pay a price when he total detroys this great country, but that is his gola to rule the kingdom only what obama doenst realize is only god rules this kingdom, not a pea brain little man little sick boy that he is...god bless this country until the corrupt liberals started to destroy it long ago, from teddy to fdr you know the lovely progressives...to the hitler today obama! he will soon be out of office and we will repeal all this horriblenss he has shoved dowon we the people throat! he has spent or as i like to say rob the amercian people with our eyes wide open...some of you are truly blind you will follow him off a cliff as i have alwasy said obama is leading you sheeps to slaughter! but there is stil time to wake-up and not go off hte cliff wiht him...obama thinks that he gets whatever he wants by his corrupt ways it's all coming to an end...we the people are going to take this great country back and stand tall and get on the right track...as obama is headed on the wrong track this is amercia not england, not france, we are not a socilist country that he wants he is ass-backwards, he wants to destry us this isnt about great medical care this is about him and his croniies making milliond if not billions, our system wans't broken to beging in with it's all the illegals and people who want all these intitlements that the democrates love to give so that the idtiots who don't want to work who want a free ride o nthe ax payers hard earned dollars so they an stay in office and control we the people, well no more...again this is all about robbing the american people blind! if you think that obama won't ration health-care did you happen to see who he just appointed last week...this man openly admits they wil lbe rationing...god help us from these evil obamaites!

American Not for Obama, when was your last thorough medical check-up? Even without EMR, I can tell that your blood pressure is through the roof. You would greatly benefit from some nice stress-reducing meditation. I also have a strong suspicion that those closest to you believe you desperately need anger management therapy, though they won't mention it to you for fear of being viciously attacked. Now, take a deep breath and repeat the following three times: "Obama is not carrying out a mass genocide." Doesn't that feel better? Now, here is something that should loosen up those tense shoulder and neck muscles of yours: Obama does not rule this country; he never has and he never will. The United States of America would never allow such a thing to happen- our great country has been bought and paid for by corporations such as Goldman Sachs, Citigroup and AIG. THEY are our TRUErulers. It's okay, American Not for Obama, all their CEOs are white men. Take a deep, cleansing breath and smile. All is well in your little world again. You're welcome.

Do your homework and get the facts. Get off the conspiracy chain.

Besides, even if I agreed with what you say, and I don't think I agree with you on any point, I'd rather have the doctors gain access to my information than take the crap shoot we have today.

Once again, this isn't about the administration, it's about us.

Don't forget the 250K plus debt they acrue in that time and the wasted youth and the high taxes and the 80 hour work weeks. Those b*s*a*ds should be making just about much as you average joe working the 9 to 5er huh?

200k a year = $130k after taxes. Factor in student loan payback of 25k/year plus another 5-10k for liability insurance. After four years of undergrad, research, mcats, four years of medical school, and at least four years of residency, the average doc is pulling in 100k. So they are in their late thirties and haven't saved a cent for savings or retirement. And they actually do something that is worth the pay. Are you really complaining about an ortho surgeon? Or surgeon in general? Do you have any idea what they do and what they have to go through to become one? I hope you go to Mexico for your next surgery. Its all the same anyway.

But by your own calculations that 250K is paid off in 10 years.

Or if the Doc lives like everyone else (<50k) for a few years he can pay it off in 3 - 5 years.

Then in another 10 years (living on <50k) he can have almost 1mil free and clear sitting in the bank. Even more if he makes good stock investment choices.

But no, every Doc I know even the one right out of residency just have to get a big house or a great appt, car, lake house and all the trimmings. and then complain about how high their costs are. And whine about having to pay such high student loan costs and insurance premiums.

Those very few that do make sound financil choices are the ones that can actually afford this type of equipment, which IF USED CORRECTLY will save tons of money, make the practice run smoother, protect patient information as well as prevent negative drug interactions and speed diagnosis. Gets the Doc in and out with more accurante treatments so they actually make MORE money being able to handle MORE patients and pay off their loans FASTER.

BTW, the newer EMR packages (those certified) are/will be designed to share data easily and securely across EMR vendors with standardized data requirements. Even now the reason that most EMR system don't interchange data is because the physicians or office managers don't allow it.

As an IT consultant I see lots of offices that deliberately don't interchange data. Ofice managers don't tell their physicians because all the office ladies are afraid someone'll lose their job. So data gets entered itno 2, 3 4 systems manually & faxed, handcarried to hospitals when it could be sent in 5 secs with no typos. Pluse some med redords keepers just don't like to see anything but battered old file folders with 3 inches of wrinkled papers, illegible handwritten notes and those nifty red, blue and yelly taggies. Replace 1000 sqfoot of filespce with 4 sqfoot of pc/server and they freak.

And just try to get a physician or nurse to carry around a tablet PC. I've seen nurses DELIBERATELY smash them because they think someone is monitoring their time from them. There's your problem right there.

I was also a consultant in the industry. I got out because the integration of electronic records was 'way too slow. I totally agree with everything you wrote here.

Thank goodness the current administration understands the need and the urgency.

The problem is HIPPA and the Doctors are afraid to look up the information. Because they might get fined for a VIOLATION.

Try this, go to the ED at a MODERN hospital that is using computerized systems. Then go back to the same ED two weeks later. The Doctors will not even check the earlier records and they will preform the same test over, even CT scans. They will not even check with the GP that the patient had just seen 2 hours prior, and still had the paper work for the exam in their hand....

I have the; dates, names of the Doctors, medications prescribed, and ALL medical records to prove this.... And they made a MISDIAGNOSIS that almost resulted in the Patients DEATH.

I dissagree, the EMR has the potential to illinate several office positions, however I know know if th kninks can be workd out in my healthcare system for a year. The training will be too much for some, but I don't see the EMR inself losing logs. I see the practices being limited by theri new systems. I see HIPPA laws flying right out the window... right along start laws.

Mr./Mrs./Miss HealthcareAdministrator -

You need to go back and get better training on your HIPAA requirements. There are procedures in place to allow unrelated physicians and hospitals to share data when necessary.

I'm laughing at you.

If you have a decent IT staff or Consultant you will have almost NO downtime.

My customers (med practices as well) have had about .001% downtime associate with equipment/software failures combined. All maintenance is done on off hours. Remote backups are in place, remote monitoring is in place, UPS's are installed and tested monthly.

Since EMR installs, patient are seen faster with fewer problems. Dr can lookup last couple of visits in seconds rather than shuffle a dozen papers in an old file. He walks in asking ?? like he saw them yesterday even if they haven't been there for a year. Let's not forget the drug interaction/allergy preventions. some Dr offices claim avg wait times have gone from 45 mins to 15 mins or less. Those that embrace it LOVE it.

Power outages also affect lights in the clinics. Who can find a file folders in the pitch black or read them? Can the labs run? Handfree BP sets? My clinics have UPS's with a minimum of 1 hour runtime on everything. That's usually enough to finish up everyone in the waiting room if they're not in a really bad way in which they're sent to the ER anyway.

What about FIRE! TORNADO, EARTHQUAKE! My clininc customers are protected. IF aliens abducted the entire building (why, I don't know) the practice could be up and running with full access to patient records in less than a week. 2 days max if we really want to puch the envelope. Takes longer to get the rest of the clinical equipment & supplies.

HIPPA provides for data interchange from different practices, clinincs hopsitals etc. Get better advice or try to learn your job.

File clerks losing their job? That's a concern? Only the crappy ones that can't type, can't speak intelligently on the phone, have no personal skills with people, can't file numerically or alphabetically, should I go on? Talk about the problem! Personnel costs alone might pay for the system! But ooh that poor file clerk. what about the poor snake oil salesman, the poor Nazi Concentration camp guard, poor Bernie Madhoff, or maybe the poor AlQaeda student pilot, how about the poor slave own, or the poor slave that no longer has an owner to take care of him. What about the poor wheelwright now that Conestogas are out of style? Give me a break. Maybe if the records are kept correctly and no typos are there and the clerk REALLY KNOW THE SYSTEM she'll actually keep her job? And she'll be able to go to another job if she needs to (maybe a better paying one) because she has SKILLZ!!! That's the economic impact right there. Lower Healthcare costs, and higher paying jobs for people who actually take the time to learn something new and useful.

The one year implementation is not intirely correct, nor is it incorrect. It depends on the implementation and the acceptance culture at the practice. But, your experience level inthis is a bit short. EVERY industry experiences the same implementation cycles as Healthcare. I have implemented systems in Med, Manufacturing, Retail and other industries and 6 mos. to 2.5 years depending on the complexity is about what you'd expect for major conversions & implementation. You are correct about the several year time frame to fully utilize the new system as well. But that is par for EVERY industry. why should healthcare be different? What if your Wal-Mart clerk had to look through a 2000 page price list to figure out the price on every item in your cart. That would SUCK! BIG TIME. Instead, Wally world, al looong time ago, invested in Electronic information systems and now you walk up, hear a few beeps, swipe your card and you're out-a-there.

True, that Dr's pay should not be an issue in this discussion, BUT it was brought up by someone that did not favor EMR use and used Dr pay as a rationale. The other posts were to dispel that false reasoning.

pucky!

You make a very good point Healthcare Mgr. It should also be noted that small practice physicians are the ones completing the EMR firsthand where as the physicians in the large healthcare systems have most if not all of the EMR completed by someone else. This further translates into trade offs of time and money. It gets complicated further with rural vs urban practice setting.

Where exactly are you a healthcare manager? Is English even your first language? Your spelling and grammar skills are non-existent and it makes me seriously doubt your claims of being a healthcare manager. You have to have good communication skills to do the job, which you do not have.

This engish clss jet? Why would you possibly comment on english? I read the posts and I was able to follow it even if words were misspelled.

Mark D-1621162 -

Sure, you can follow what is being written if you work at it, but a healthcare professional had BETTER be able to read and write English well, or have someone on staff who can translate properly. Otherwise, your medical records won't be worth much.

Whoever Healthcare Manager is, his/her qualifications are in question by anyone educated for good reason. This person is implying, if not outright saying s/he is in the healthcare field, but his/her writings indicate that is highly unlikely.

Obama "may" have his agendas, but the EMR ?? is independent of that. EMR is a tool. It can be used by Socialist or fascist or anyone else, but EMR can greatly increase the uality and decrease the total cost of patient care. PERIOD.

And when I get too close to some magnetic field that my card is erase?

what then if no one can copy it?

With all due respect, this may be more a matter of time, training and acceptance level on your part or your office staff.

Some practices I know use a combo system with paper forms for the physician to take into the exam room and fill out as usual but given to data entry persons after the visit. Or an attending nurse can do the entry whle the Dr does the exam & talk. Depends on your style.

Patient time doesn't suffer and you still have the nice looking documents that don't EVER get lost because they're in the system backed up and can be reprinted or transmitted.

But there are lots of ways to to tweak you own personall internal ops to make sure the patient gets the time and computer time is limited.

Shayde, that doesn't work too well in the rural practices where they are 1 or 2 physicians. The doctor shortage is most acute in those areas.

It's only 40 years late, but it's none of the government's business. It cost me money every time Obama opens his mouth? Enuffff!!!

That socket wrench doesn't need information from any other socket wrench in order to do its job properly.

But if the mechanic could get 1 tool that would save him 30-60K for hiring other mechs in his shop, keep better records of his customers, better maint history on the vehicles, keep him from ordering the wrong parts, or putting the wrong fluids in the vehicles, keep track of warraty works and recalls, AND send that same info to his affiliate shops (since he's making more money and can expand now because he can handle more customers and get repairs done faster and therefore gets a better reputation and thus more customers) so his customer can get that same care at ALL his shops.

That would a pretty sweet deal wouldn't it?

Amen brother

Ideally it would be.

Market forces would have done this decades ago, but the healthcare industry is so polluted by regulation, medicaid, medicare, politicians investing in and then supporting insurance companies via laws that there are NO market foces really involved any more.

So quality suffers, supply goes down, costs go up and still the gov't does thing to make it more expensive.

you see, what the new healthcare laws are going to do is exactly what happened to the mortgage industry in the 90's. EXACTLY the same thing, same policies, same mechanisms, and we will have the sme results.

But, EMR systems will make things better

EMR would stop diagnoses mishaps, almost completely. Patients have the right to check their records when ever they want, so if any info is not correct they can get it changed.

@igmg70 "Patients have the right to check their records when ever they want, so if any info is not correct they can get it changed."? Right!...and any competent hackers anywhere on the planet can destroy or modify your "private" records. Do you trust the government to follow through on your request to correct a mistake, making sure it's corrected in all the places it hides? All it takes is a "restore" from backup files to wipe out the correction (assuming it got made in the first place.)Where are these private records archived? What happens when a "denial of access" hack occurs when a doctor needs immediate access to your records to perform emergency surgery or other treatment? No one is going to have that on hand...no need to, because it's all on the EMR. Of course everything our government creates works perfectly from day one forever.