Health IT

Why one doctor doesn’t use electronic medical records: MedCity Morning Read, Jan. 29, 2010

People who don’t follow the health industry closely frequently wonder why more doctors don’t use electronic medical records systems. After all, information technology has helped most industries increase efficiency, wouldn’t it do the same for health care if doctors would just do the same?

Highlights of the important and the interesting from the world of health care:

Why one doctor doesn’t use electronic medical records: People who don’t follow the health industry closely frequently wonder why more doctors don’t use electronic medical records systems. After all, information technology has helped most industries increase efficiency, wouldn’t it do the same for health care if doctors would just follow suit? (A widely cited article from the New England Journal of Medicine from 2008 found that only about 13 percent of doctors use EMRs.) For anyone who’s ever wondered why those numbers are so low, a blog post at HospitalImpact by Dr. Robert Teague is worth a read.

As Teague indirectly points out, while most software is designed with the key end-users in mind (in this case, physicians) EMR systems generally are not. EMRs were designed to be back-office automation tools, that is, they’re supposed to facilitate billing betwwen medical practices and insurance companies. And many of them do that well. Succinctly put, EMRs don’t help doctors do their jobs. If they did, doctors would use them.Until that happens, don’t expect doctors to rush out and spend tens of thousands of dollars on the software, even if they get government incentives to do so. As Teague says:

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I have long contended that if an EMR delivered value to clinicians in performing their work, cost would not be an issue, much less adoptive resistance. Connectivity to all needed clinical data and among all parties involved, a user interface that supports the clinical task, and automation of data collection, analysis and process flows will go a long way toward enhancing the value proposition.

Another argument for home health care: USA Today examined the state of the nation’s 15,000-plus nursing homes and in many of them, it’s not too pretty. One-in-five “consistently” received poor quality ratings, according to an analysis of Medicare data. The federal agency that oversees Medicare recently began assigning nursing homes one to five stars for quality, staffing and health inspections, as well as an overall score. And surprise, surprise, nearly all the homes that received one or two stars were run by for-profit companies, USA today reported. More evidence, maybe, that health care and profits don’t mix. Alas, that’s the American way. Cue up the chants of “We’re number 37!”

A path forward for health overhaul? Rather than be the one millionth blogger to ruminate on what President Obama said in the State of the Union address, Ezra Klein takes a slightly different tack and discusses what the president didn’t say. Once again, Obama failed to articulate any sort of clear path forward on health care, not bothering to even mention it until nearly halfway through the speech. Obama should know by now that the overhaul isn’t going to move without some tough talk publicly (and likely even tougher talk behind closed doors) that would give Congressional Democrats a little political cover as they try to pass the legislation over the objections of re-energized Republicans.

Should the House simply swallow the Senate bill, which is 90 percent similar to the House bill anyway, and thereby avoid another vote in the Senate? Should the Senate pass a combined bill through reconciliation, which would require only a majority vote? Should Congress scrap the whole thing and start over? And what about any sort of timeline? Obama’s failure to lead only creates more confusion and doubt as to whether overhaul will happen at all.

If health-care reform dies, it will not die in a climactic vote. It will die amidst everyone pledging their continued commitment to the issue, but their aversion to doing it right this second. Obama could have quieted those fears … He didn’t.

Shoeless running. Seriously? It seems highly counterintuitive–though maybe I’m just brainwashed by athletic-shoe companies–but research by Harvard scientists suggests that running barefoot could be better for your feet. Of course, the key words there are “suggests” and “could,” but the possibilities are nonetheless eyebrow-raising. Running barefoot, in which the runner lands on the ball or middle of the foot, creates less of an impact on the foot than the heel-jarring style of shoe-aided running most of us do. What the researchers don’t know is whether less impact leads to fewer injuries, though it’s certainly not farfetched that it would.

And there are plenty of barefoot enthusiasts, some of whom run in FiveFingers, minimal shoes that look like gloves for the feet. “It’s fun, it’s tactile, it’s stimulating,’’one barefoot enthusiast said. “It kind of matches the notion that our body evolved to work as a runner . . . that’s really how the body is made to work.’’

Photo courtesy of Flickr user juhansonin