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Improving The Physician’s Experience With EHRs: More Training Required

Physicians need at least three to five days of training on new electronic health record (EHR) systems to achieve the highest level of overall satisfaction, but nearly half of new users get three or fewer days of training, according to a survey.

AmericanEHR Partners surveyed physicians’ experiences with EHRs to achieve some meaningful use requirements. (The group is a web-based resource for EHR system selection/implementation developed by the American College of Physicians and Cientis Technologies).

AmericanEHR Partners used a 139-question online survey to collect data form physicians, nurse practitioners and physician assistants about their use and satisfaction with EHRs and health information technology. Survey data from more than 2,300 physicians in conjunction with five different professional societies was collected from April 2010 to July 2011. Results appeared at the group’s website.

There were Read more »

*This blog post was originally published at ACP Internist*

Solo Practice Vs. Integrated Health Systems: What’s Best For Primary Care Reform?

The buzzwords of cutting-edge primary care reform – the medical home, coordination of care, electronic health records – have usually been associated with large integrated health systems such as Intermountain Healthcare, Group Health, and Kaiser Permanente. If you believe the arguments that economies of scale and financial resources give such organizations built-in advantages over the traditional small group practice, you may be inclined to believe that solo practice is going the way of the dodo. Indeed, immediate past AAFP President Roland Goertz, MD, MBA penned an editorial a few months ago, “Helping Small Practices Survive Health System Change,” that, while touting some services that the Academy offers family physicians in these practices, betrayed a decidedly pessimistic outlook on their long-term future.

Not everyone agrees, however. In the September issue of the Journal of Family Practice, Jeff Susman, MD cast solo practices as vital engines of primary care innovation: Read more »

*This blog post was originally published at Common Sense Family Doctor*

Will Patients Accept The Patient Portal As “The Next Big Thing”?

There seems to be an inverse relationship between the amount of spin one hears about “the next big thing”…and reality.    First it was EMRs and virtual e-visits, then social media, and now patient portals seem poised to be next big thing.  The drumbeat of vendors and pundits is unmistakable….physicians that don’t adapt will be toast.   It can all sound pretty convincing until you ask to see the evidence.  What do patients think?

Take the physician patient portal.   If you read between the lines, patient portals are frequently being positioned as the new “front door” to physician practices.   By signing on to a secure website patients will have real time access to the electronic health record and will be able to communicate with their physicians by e-mail.   Additional patient features include being able to schedule an appointment with their doctor, reading their test results and refilling prescriptions.  But despite these features, according to John Moore at Chilmark Research, “nationwide use of patient portals remains at a paltry 6%.”

Ok… so now we know what vendors and pundits think about patient portals. What about patients – what do they think? Read more »

*This blog post was originally published at Mind The Gap*

Doctors And Work-Life Boundaries: Keeping An EMR In Its Place

I’ve had a longstanding policy in my office that routine prescription refills will only be addressed during regular office hours. No evenings; no weekends; if you need a refill of your long-term chronic medications, you need to call during regularly scheduled office hours, five days a week. You can leave a message if you like, but you should not expect us to call in the medication until the office is open.

The main reason for this policy has always been medical: prescription medication requires appropriate monitoring. From the moment I hung out my shingle, I’ve made it my habit always to write enough refills on your medication to last until the next time I need to see you. In all likelihood if you need a refill, what you really need is a visit.

The logical reason for the policy is the need to consult the medical record before authorizing refills. And when those records are contained on bits of dead trees on shelves in the office, there’s no way I can access them if I’m not physically there. I’ve been known to drive out to the office at decidedly odd hours for the express purpose of consulting those records so that I can provide appropriate care to my patients. That has always been the bottom line for me, and always will. Read more »

*This blog post was originally published at Musings of a Dinosaur*

Implementing An EHR: 5 Quick Tips

Dr. Jay Anders, the CMIO of EHR vendor MED3000, offered a few tips during a Medical Group Management Association (MGMA) session on implementing an EHR successfully:

1. Make a clear communication pathway. Everyone needs to know what’s going on, from the physicians to the receptionist.

2. Clearly identify the needs of every physician who is going to use the EHR. The needs of an internal medicine doctor aren’t the same as a dermatologist. Make sure the EHR meets those needs.

3. Get a physician champion for the EHR who will be responsible for talking about the project to peers and answering questions, and be the first person to implement it. Pay that person for his or her time spent in championing duties.

4. Some people need more time than others. Don’t let a resistant doctor stop the implementation. Develop a plan for dealing with resisters that includes how you’ll respond to negative comments, how to implement other colleagues despite the resister, and how to sell the benefits of the EHR to the resister.

5. Expect the EHR implementation to be time-neutral. Most EHRs don’t save time; their value is in improved patient care and documentation, which leads to better reimbursement.

*This blog post was originally published at ACP Internist*

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