Obama are you reading this article, if not, do so and don't spend that $27 billion on going digital. As a matter of fact: STOP SPENDING on any thing till we get back on our feet.

They're forgetting the fact that Doctors, such as the case in emergency hospital visits, will instantly have full access to a patients medical history. Saving time, money, and lives with this resource. Besides it was an inevitability; soon all that isn't digital will be. Righties: What have we gained from trillions spent in the middle east? Are Iraqi friends are showing the love with daily Christian killings. Go Team.

It is going to save papers (going green technology, e-file), save administrative costs, save cabinets/boxes/folders/rental places to keep records(papers), save pens/stamps/documentation, save stamps and opportunity being stolen, save time, ... at the end it is saving the rising of healthcare cost in terms of just one word, "saving".

I have had care from the VA and more recently from Kaiser. The integrated systems are a wonder. Every doctor knows what medicines, what history, what injuries and what tests you have had. Each doctor knows your immunization, and doesn't waste time on duplicate questions. Appointments are centralized and much easier.

I seriously question the validity of the study's conclusion.

Of course it doesn't help the quality of health care, as changing format from paper to digital is not going to make a doctor better. As the article stated, even when combined with software that prompts the physician to perform a test or prescribe a drug, care does not improve as the prompts are ignored. Pay health care practitioners what they are worth so they do not have to see excessive numbers of patients per day to pay the bills and make a decent wage for themselves, and quality will improve. Look at the Cleveland Clinic health care system, where all doctors are salaried, and you will find they rated at the top. The system in this country has to change, not just the way care is documented.

There is no doubt in my mind that the digital records have saved tremendous amount of time, specially critical time in emergencies.

The old fashion way, all lab reports had to be on a slip, making their way to the patient floor (or doctor's office), and hopefully would be placed in patient's chart in time for their doctor to see it. So it goes with x-ray reports, MRI, Scans, Physical Therapy reports, Nurse's progress notes and specially consulation reports with specialists.

Here you have instant access to records, without asking Medical Records department to find the chart and send it up to you, and access to all test results as posted and available immediately.

There is no way the digital records and integrated records will ever go back to it's previous state. Ask your doctor.

There is indeed a standard for health records, known as HL7. At one time I had to adapt some medical billing software to this standard but in my opinion it is very messy to work with. I'm not even sure it is still a standard.

I now get health services from the VA and from a University health center. The VA has been on line for some time while the local University health complex is just going on line. These systems are really not well designed, for example the VA system lets the Physicians Assistants make appointments but doesn't force them to make a related lab appointment or otherwise indicate there is no lab required.

The VA system has an on-line service which lets you keep track of your own health and procedures, however you have to enter all the data yourself. It would be nice if the VA data could be downloaded but there are some serious security concerns, as indicated in the HIPAA specifications. My VA records did, however, become available to the VA folks here after a cross country move so they are, I believe, linked nation wide for the most part. I don't think my health care has improved at all as a result of this automation.

The University Health Center system may turn out to be O.K., and the doctor shows up in the exam room with a wifi laptop and enters data in it. In some cases, when my primary care doctor has ordered a test and included one he knows will be needed for a visit to another part of the facility, that other facility never checks to see whether the test results are available. My PCP has to FAX the test results across the street and a block down the road just to be sure they have the results.

The University system does have an external patient portal in which one can send notes to the doctor and recive responses- Only problem here is that the doctors still, after 2 years, are unable to easily send a response. They would rather call or send a FAX.

Time will tell but it's going to be a slow process. I have worked in Medical Records and Billing software design for 30+ years and only know of a very few instances where there was a gain in patient care. There are indeed great gains in billing efficiency.

I help build electronic medical records computer applications. So, what is really the reason to put medical records in electronic form? Sure its 'cool' to be high tech and put the data in a computer and there are some nice functionalities available. But what really is the reason to bother to do that? I'll tell you, it is the ability to analyze the data in digital format. I can do a query on the information. I can look to see if patient medications were given on time. I can see if all patients with temps above 102 at admission and were given a culture and antibiotic within 2 hours of admission really had a shorter length of stay or not. If you put data in, we IS people can take it out and make it dance. If you ask an intellegent question that is quantifiable we can help you see the answer. No more guessing did that work, you can see with concrete data. And THAT is where electronic medical records make sense.

The sole purpose for this push for online healthcare data is so the companies that maintain it, like equifax, etc. can sell your personal health information to insurance companies, and credit rating companies, and potential employers, landlords, and anyone who wants to pay the price. Application forms will have release forms just like the credit info release forms. If you don't give them permission to look at your health data, then no go. You will lose control of your health care data, just like you lost control of your financial information. This was lobbied into the law by all the companies that want access to your health information. It had nothing to do with better health care.

If you put data in, we IS people can take it out and make it dance.

And there's the rub. I work in the legal field and we have a fantastic case management program that does the same thing. The problem I have is getting people to put the information IN! And doctors are a lot like lawyers in my experience- the young ones will adapt to the new technology and look for new ways to make it work for them while the "old dogs" will fight it at every step. Going to take a long time before we achieve full integration of records.

Ultimately the medical community will go digital without government money or encouragement as it will help to contain costs. Improvement in the quality of health care through digital patient records was never the promise to begin with - at least so far as I recall.

What this country desperately needs is more primary care physicians. Simply converting all patient records to digital form is NOT going to increase the number of doctors. Nobody ever chose to go or not go to medical school based upon record keeping.

Simple easy steps to improve health care

1- make insurance available and affordable to everyone

2- have doctors actually spend more than 5 minutes with their patients

3- stop requiring people to change insurances and doctors every time they change a job so they can actually build up and keep a relationship going with a doctor.

4- make health care itself affordable

Improved patient health-care is a misnomer here because patient health-care is in the capable hands of the nursing staffs of the hospitals. What will improve though will be the doctor's instructions to them since the nurses will no longer be forced to try to decipher the doctor's handwriting which I would bet the farm has caused more than one problem for the patient and thus the hospital. Get more nurses and cut down the burden that they are forced to carry and watch for an improvement then! Nurses GOOD!! Doctors QUESTIONABLE??

So, since there is no positive effect on the quality of care provided, it seems that there are only disadvantages to putting health care information on line. Unscrupulous hackers, insurance companies, employers, and even government agencies could possibly have access to and use this information against people without all the hassle of breaking and entering into a secure filing office.

Imagine a potential employer having access to medical records indicating you have a family history of mental illness, or cancer, or high blood pressure and comparing it to the other applicant who doesnt have this in their record. Or a hacker who finds out you have AIDS and emails it to family and friends to ruin their reputation - especially if the person is a public figure.

This information won't be much safer than our credit card numbers, but much more potentially damaging.

The time period they are looking at is when Electronic Records were just coming of age and not in widespread use. The products have changed and their ability has changed. I have more actionable data available more rapidly than could ever be possible in a paper chart. Want to run a report to see which patient needs to be notified of a medication recall...done. Want to know which diabetic patients have had an eye exam...done. Want to know the population that needs a mammogram...done. A paper chart cannot compete. Period.

Hey wasn't that the main excuse for the whole health care bill, the magic paperless system that will solve all problems.

Then they are using the wrong EHR. The system should be intuitive, make sure all charts are online and available, all orders, notes and summaries are accomplished online, and it is designed so that its patient care first and foremost. Not billing and costs.

I used to implement EHRs, and this report must be from Physicians that are resistant to using the EHR. I used to hear from Docs that "I'm a Doctor, not a clerk". You're right, you're not. But, give the EHR a chance and it is a great tool in treating patients.

In addition to my last post. If someone comes in and says they are going implement you a computer system and it will save work and money. Run them out because they are lying to you.

My wife is a nurse at a general practice. She was not a computer user, except for online searching/ordering, and e-mail. So it was with some trepidation that she trained for the introduction of EMR. She has been with it for over two years and loves it. The main advantage is improved workflow. Information is recorded and passed to and from the caregivers, with a record of who did what when, and with what authority. When a patient calls in with a question, it is easy to respond with the most current data and to record problems/responses electronically. No longer is time wasted looking for “lost” or misfiled records. Throughout the day it is easy to see what remains to be completed, calls made, prescriptions sent (electronically) for each patient in the practice. Good ridance to yellow post-it notes on patient charts.

I cannot judge if patients health is affected through the use of EMR, but it surely improves patient care.

From someone who uses them every day, EHRs are a mixed bag

ADVANTAGES

Legible notes, legible notes, and legible notes. This is the best thing I can think of when it comes to EHR use.

DISADVANTAGES

It takes me an extra 45 minutes to an hour a day just to do all of my notes well. Just because they're legible doesn't mean that the information in them is worthwhile. Plus, many of these EHRs have 'dropdown' menus and templates that build your note as you create it. It's a royal pain in the a** to do sometimes because not everyone presents with a problem that fits perfectly into a prebuilt template. So, you build notes on the fly which takes longer because you're typing your thoughts in. I've read other physician's notes where they just cut and paste the previous note without really changing anything, and that's a legal disaster waiting to happen. Dictation is still the way many specialists go, because you can dictate way faster than you can type (most of us, anyway). My only saving grace is I took typing in high school, and it's the only saving grace that's kept me ahead of the game so far.

Not all EHRs talk to each other. When I get a new patient, I have to start from scratch. Even if another physician's office uses the same EHR, you can't just upload the file into the program. You literally have to start over again. That's frustrating for me and for patients.

If your IT infrastructure goes down, you're screwed.

It costs money for upkeep on an annual basis. Gotta pay for an IT guy, gotta buy computers for every exam room and replace them every so often, and gotta pay for the annual license for the program. More expensive than buying pen and paper.

And having said all that I"m heading back now to finish my last few notes of the day. They've got limitations, but man it's a helluva lot better than reading the last doctor's chicken scratch trying to figure it out.

"The push is largely based on the assumption that moving to electronic from paper records will improve communication and reduce medical errors. But that may not be so."

The government has to get off its butt and make it a LAW that all EMR systems have to be able to communicate with each other. Period. We have two hospitals in our town and two major physician groups. NONE of them can communicate with each other, even though they all have EMR. What is the point of having electronic records and computers that allow retrieval 24/7, when they can't even talk with each other? This is just stupid! And REALLY bad, VERY expensive patient care, since there is a lot of duplication of care, delay in treating what is already known, etc.

If someone comes from out of state: forget it! Start from scratch, reinvent the wheel, get that $3000 MRI you don't need. If the government wants to save money, then they need to suck it up and make it a law that all EMS's HAVE TO BE COMPATIBLE WITH EACH OTHER!!! End of story. This is not rocket science!

I've seen it work, with the Alaska Native Hospital in Anchorage, BUT, the right personnel have to be given access to the info, the time to review it, and the right kind of team that will work together instead of waging turf wars (I am a pharmacist). If things stay like they are now (in the community, for example) and the different professions involved in health care don't work together and respect each others' specialized educations, then it is not worth the bother. Seriously.

Direct quote from the article ....

"Electronic health records systems that include this software have been shown in other studies to significantly improve health quality."

so how is this ONE study relevent?

slow news day?

General Electric Corporation is heavily invested in the marketing of digital records to the the health industry. Along, with Philips Electronics, GE is purchasing elder-care facilities in order to get the machines on properties.

Who wants every word that they say to a medical professional, on a computer for ALL to see? Insurance companies immediately read the notes and a patient no longer has any privacy.

Got a freckle on your chin? Note on record. Now, the insurance company will begin to have that freckled monitored to see if it will potentially become cancerous.

Won't be long before humans will be required to have their personal information inserted under the skin for a wand to just slide over and record history into the compute. We are way past "1984" and the world is getting colder by the minute.

From a nurses standpoint. Many hours spent typing into a computer when admitting a patient. No eye contact during admission. Printed out records never get read. Giving report to another nurse is still verbal and always will be, a patients history is never black and white, everyone has shades of gray which is passed on verbally. It is an incredible waste of time in the department where I work. But I guess we all know that patient care is now way down the ladder compared to documentation. How sad.