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International EMR: The Netherlands

I recently had a few days out of the office and decided to visit Amsterdam.  I had never been there before and thought I would look up what’s been going on in the Netherlands with regards to electronic medical records.  It turns out that approximately 90%+ of Dutch medical doctors are using EMR and EHR systems, according to a Canadian study quoted in Full Electronic Medical Records Still 20 years Away.  In a slightly older post from 2008, Canada Lags in Electronic Medical Records, the number quoted for Netherlands docs was higher, at 98%.

This post struck me as very interesting because of the information regarding just how electronic were medical practices in various countries in Europe.  Not only does it discuss EMRs, but also PDAs and websites of practitioners, which gives the reader a feel for just how technologically savvy various countries’ docs really are.  A listing of sources is at the end to let you know they didn’t just pull the numbers out of the air.

A motherlode of information (Electronic Patient Record in the Netherlands) about the early days of the Dutch EMR experience was presented in 2002 and sounds eerily similar to what we are facing in the U.S. today.  The issues are so similar in some cases that it’s tempting and begs the question to predict what will eventually happen in the U.S.

Dr. West is an endocrinologist in private practice in Washington, DC.  He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine and opened The Washington Endocrine Clinic, PLLC, as a solo practice in 2009.  He can be reached at doctorwestindc@gmail.com.  Some of his blogs also appear at EHROutlook.com.

October 13, 2011 I Written By

Dr. West is an endocrinologist in private practice in Washington, DC. He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC in 2009. He can be contacted at doctorwestindc@gmail.com.

Easing the Pain of Electronic Medical Records?

The Huffington Post recently had an interesting video in which an orthopedic surgeon poo-poos EHRs because they waste time and cause him to have to type up his notes.  He tries to say that dictation is the way to go, in order to ease the pain of using electronic medical records.  A word of caution that this video is a paid advertisement for Nuance, of Dragon Naturally Speaking fame, and so the “doctor” might actually be a paid speaker.

He subsequently goes on to say that, well, at least Dragon Dictation allows him to avoid typing notes.  And that he dislikes templated notes because he finds them hard to read and impersonal.  But he seems to ignore the possibility that templating your own office notes is often a far better approach than using templates an EMR company sets up on their own, and many EMR systems nowadays allow this readily.

I have to say that I found this irritating although I love Nuance’s products, especially the free iPhone app Dragon Dictation, which works very well.  It was irritatin because it was at odds with the hard work and creativity doctors need to have in order to make it though all the training hoops of learning to live digitally.  I don’t buy that they can’t or shouldn’t have to figure out the another hoop to jump through, especially after they’ve pledged in medical school and residency, over and over again, ad nauseam, that they support lifelong learning.  Templating has allowed me to move from patient to patient without leaving a trail of unfinished notes, and it didn’t take that long to get going.  It’s a very customizable process that can be just as personal as anyone likes it, depending on how many “fill-in-the-blanks” areas that you decide to set up in your notes.  Templating notes has saved me so much work and protected my patient’s information that I couldn’t pass up this opportunity to support it.

Dr. West is an endocrinologist in private practice in Washington, DC.  He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine and opened The Washington Endocrine Clinic, PLLC, as a solo practice in 2009.  He can be reached at doctorwestindc@gmail.com.

September 16, 2011 I Written By

Dr. West is an endocrinologist in private practice in Washington, DC. He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC in 2009. He can be contacted at doctorwestindc@gmail.com.

Going Mobile: How EHRs and Mobile Technology are Shaping One Physician’s Practice

For today’s blog post on going mobile with health IT, please join me over at EHROutlook.com!

Dr. West is an endocrinologist in private practice in Washington, DC.  He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine and opened The Washington Endocrine Clinic, PLLC, as a solo practice in 2009.  He can be reached at doctorwestindc@gmail.com.

September 13, 2011 I Written By

Dr. West is an endocrinologist in private practice in Washington, DC. He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC in 2009. He can be contacted at doctorwestindc@gmail.com.

International EMR, EHR — Insider’s Perspective on NeHTA

A recent reader recently commented on my earlier post, Government Sponsored E-health Initiatives, and brought my attention to his blog, Australian Health Information Technology, which focuses on the Australian government’s EMR initiative NeHTA.

David More MB, PhD, FACHI, describes himself as a ‘dissident’ who is a bit worried about this organisation.  Have to say that he sounds like a fun guy (and certainly very interesting guy) already.  You may want to poke around his site to get more information about NeHTA in general.  He posts interesting tid-bits such as noting the number of weeks late that NeHTA is in delivering their plans for what sounds like stage I of their version of the US Meaningful Use plan.  Dr. More also cites breaking news articles regarding government EHR plans from both Australia and the US.  Bon apetite!

Dr. West is an endocrinologist in private practice in Washington, DC.  He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC, as a solo practice in 2009.  He can be reached at doctorwestindc@gmail.com.

September 6, 2011 I Written By

Dr. West is an endocrinologist in private practice in Washington, DC. He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC in 2009. He can be contacted at doctorwestindc@gmail.com.

Style and Substance — EHRs Need Both

Greetings to all my readers out there!  For today’s blog post Style and Substance — EHRs Need Both, I invite you to visit me over at EHRoutlook.com. Ann Zeiger was kind enough to invite me to write on a topic that interests me (and hopefully her and her readers) a couple of times a month.  It’s been a good working relationship, and so I hope you’ll take the time to take a look around their site.  I found it to be actually quite packed with good information and perspectives on electronic health records and mobile healthcare technology.  Bon apetite!

Dr. West is an endocrinologist in private practice in Washington, DC.  He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC, as a solo practice in 2009.  He can be reached at doctorwestindc@gmail.com.

August 29, 2011 I Written By

Dr. West is an endocrinologist in private practice in Washington, DC. He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC in 2009. He can be contacted at doctorwestindc@gmail.com.

EMR Development, Where are the Doctors?

John Lynn, over at EMRandEHR.com recently wondered about Depth in an EMR Conference.  He recently attended the Health Tech Next Generation conference in San Francisco, where few doctors seemed to be present.  This is such a classic blunder in health IT: not checking with the end users to make sure what you are designing is on the right track.  To be honest, it’s what killed our first EMR experience and led us to fire the EMR vendor.  There was no clearly tangible evidence that a medical doctor was involved at all in programming the thing.  We felt like we were beta testing their system for them as they worked out “bugs” based on our suggestions.  Frankly, we should have requested three months worth of consulting fees in the end, but that’s a story for another time.

John also made the comment that he had never seen a true EMR conference focused on doctors, practice managers, and actual users of the EMR.  Hmm… I think Practice Fusion Connect 2010 did this to a large extent.  Lots of pics and videos from the event can be found here.  Better yet, I’ve already scheduled time to go the next one, Practice Fusion Connect 2011, which is being held in SF on 11.11.11.  It’s slated to be about  five times bigger this year according to my inside sources at the company, and they are expecting about 1,000 attendees.  When I was there in 2010, it seemed heavily focused on the end users, who seemed to make up a large portion of the audience.

John mentioned the important and puzzling question of “how do you get enough doctors together at an EMR conference?”  I’ll admit that one’s a tough nut to crack, since you are asking private practice docs to give up income to get to a conference during a weekday, on which most conferences like this are held.  If it’s held on a Saturday or over a weekend, that might help.  If the target audience is employed and salaried, then it’s not as much of a problem getting them there since they aren’t really losing any pay/income.  The problem with that is: employed docs generally don’t make buying and implementing decisions.  Those of us who do, typically are in small practices of our own.  An interesting conundrum to solve, but bring it on.  More conferences like this are definitely needed since American healthcare runs on private practice doctors, their managers, and their staff.

Dr. West is an endocrinologist in private practice in Washington, DC.  He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC, as a solo practice in 2009.  He can be reached at doctorwestindc@gmail.com.

 

 

 

 

 

 

 

 

 

August 15, 2011 I Written By

Dr. West is an endocrinologist in private practice in Washington, DC. He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC in 2009. He can be contacted at doctorwestindc@gmail.com.

Practice Fusion in DC for summit on interoperability

Recently had the pleasure of spending a great night out with our friends Emily Peters and Tom McMennamin at Practice Fusion.  After serving 22 patients in a very busy day for us yesterday, we had a blast at Ris since E & T were in town for a local conference to discuss the importance of EMR and EHR interoperability with major government institutions.  Various government reps were present for this two-day extravaganza of the minds, including those from the Social Security Administration.  Turns out that PF is working on developing many things, including a bridge to communicate important medical records electronically to the SSA efficiently when patients apply for disability benefits support.  I’ve completed two such requests for records recently in the past two weeks and it’s currently all on paper.  What a pain and how inefficient!

After a long first day at the conference, Emily and Tom were still alive and bursting with energy enough to meet up with several local area docs and practice managers to discuss the latest and greatest updates.  We got to ooh and ahh at all the progress in Practice Fusion’s ongoing meteoric rise over the past several years.  They are now around 100 employees and will be moving into a fantastic new larger space in San Francisco within the next few months to better accommodate their mission to provide a great EHR, EMR system with top-notch interoperability.  Go PF!

Dr. West is an endocrinologist in private practice in Washington, DC.  He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC, as a solo practice in 2009.  He can be reached at doctorwestindc@gmail.com.

August 10, 2011 I Written By

Dr. West is an endocrinologist in private practice in Washington, DC. He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC in 2009. He can be contacted at doctorwestindc@gmail.com.

EMRs: First, choose wisely.

My friend John Lynn, who runs the Healthcarescene.com, is always warning people to choose their EHR wisely in order to not get hurt later.  I could not agree more.  After having heard my story throughout various blog posts, my closer readers know that my first attempt was a complete failure.

The post found here about a meltdown in a Delaware office of three doctors echos a lot of what made us cry at the end of the day back in late Janurary of 2010.  However, with more doctors on board in their case, there has been (and possibly still is from the sounds of it) more pain, time, money and frustration involved.

For some reason I can’t explain, I found it frustrating that the state government consultant really only is now playing a role in watching as the doctors get to pick up the pieces of their shattered dreams and start over after shoving $40,000+ down the drain to gain “experience” in how to select their next EMR, if they continue at all with it.  It does, however, highlight a potentially excellent and much needed role for lists of government-sanctioned EMR systems (which I have been skeptical of in the past) and consultants who can help before doctors jump in unaware and get burned.

Dr. West is an endocrinologist in private practice in Washington, DC.  He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC, as a solo practice in 2009.  He can be reached at doctorwestindc@gmail.com.

August 4, 2011 I Written By

Dr. West is an endocrinologist in private practice in Washington, DC. He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC in 2009. He can be contacted at doctorwestindc@gmail.com.

Data breaches and EMRs: bad guys or just dumb mistakes?

I love this post by George V. Hulme at CSO Online because it really highlights my high level of skepticism regarding all the need for worry about encrypting everything to death where electronic medical records are concerned.  Yeah, yeah, yeah.  I’ve heard it over and over, ad nauseam.  I don’t necessarily disagree that data security is important, but just please someone name me some examples of where a nefarious miscreant was purposely trying to steal protected health information (PHI) electronically with hacking.  I’m sure such documented incidents must be out there somewhere, but they don’t seem common since I’ve never heard of any actual cases.  Even the strange one reported (but not really well referenced) in the above post was, okay technically crime, but not electronic at all.  The criminal cited in the story was apparently trying to manually steal what sounds like a hardcopy paper file from the doctor’s home.  I’ve always told my colleagues and friends, “What the bleep would anyone want with some average patient’s health information?  And who’s gonna go to the level of sophisticated, tech-savvy theft to get it?”

It really seems like crazy paranoia to me to think that anyone cares about Mrs. Smith’s medication doses, whether she smokes or has a beer every now and then, or when she was last seen in the office.  Come on, people, that’s not going to make anyone rich — pretty much has no street value at all on the surface.  So I ask again for your assistance in throwing me a bone.  Help me understand where the rubber meets the road and we really need to go crazy with overly expensive and extreme technology to avoid electronic data theft.  Someone think up the next blockbuster summer movie script.  “The Net III”?  I’ll take crazy Sandra Bullock movies for $100, Alex.

Dr. West is an endocrinologist in private practice in Washington, DC.  He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC, as a solo practice in 2009.  He can be reached at doctorwestindc@gmail.com.

August 3, 2011 I Written By

Dr. West is an endocrinologist in private practice in Washington, DC. He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC in 2009. He can be contacted at doctorwestindc@gmail.com.

First Statewide EMR in Hawaii?

Admittedly, Hawaii is a small state, but it’s an interesting statement to make when one EMR company gets invited to supply the state-run health system’s sole EMR.  Of course, this doesn’t mandate anything for doctors in private practice, so we’re talking about only 12 hospitals and 2 state-run clinics.  Siemens will begin actively providing electronic medical records to Hawaii in November 2012 for around $29M, so hats off to them for getting this very important contract.  Wonder how EMR incentive money works if you are a doctor to a state-run medical system.  Does the hospital just get the incentive money since the doctor technically didn’t do the selection, implementation and reporting?  It would seem justified to me.

Dr. West is an endocrinologist in private practice in Washington, DC.  He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC, as a solo practice in 2009.  He can be reached at doctorwestindc@gmail.com.

August 2, 2011 I Written By

Dr. West is an endocrinologist in private practice in Washington, DC. He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC in 2009. He can be contacted at doctorwestindc@gmail.com.