An HIT Moment with … is a quick interview with someone we find interesting. Ann Mai, MD is an internist in private practice in Irvine, CA.
How have your patients responded as you’ve incorporated additional technology into your practice?
My patients have been very positive about the additional technology. They enjoy receiving their results online and being able to communicate online with the office. Most have expressed that it saves them time and they feel that it makes the office more accessible at their convenience.
Do you think more doctors would use (and not just acquire) EMRs if the government helped make them affordable?
No. Doctors are stubborn and a small number may be motivated by government funding for EMRs and may acquire the systems, but to ensure use it is even harder. I know many doctors who have acquired systems out of their own pockets and never even implemented the systems. If there was an incentive to use the systems such as being related to reimbursement, this will most likely motivate doctors to use an EMR.
How do you respond to other physicians who resist technology such as EMRs and e-prescribing because they believe it’s too costly and time-consuming?
I agree EMRs and e-prescribing are costly and time-consuming in the early phases. The upfront costs deter most physicians; however, after being a user of these systems for over five years, I believe they not only save me time, but money, and made me more compliant in my documentation and billing. Perhaps they even self-generate more income because they make the documentation process more comprehensive and recommend more appropriate codes to bill.
What’s been the good and the bad about implementing and using EMR, e-RX, and your patient communication tools?
Good – saves time, money, and the comprehensive documentation of each visit. Helps in coding for those who never learned how to in school (none of us ever did). Never have lost files in the office. Messages are not left on sticky notes that can get lost.
Bad – one wrong click of the mouse can bring up the wrong patient or wrong medication to prescribe or wrong diagnosis to label a patient with. Doctors and staff have to be careful with data entry and take frequent breaks to avoid eye strain and ergonomic problems – back pain, carpal tunnel … Less eye contact with patients — patients do get used to this and appreciate it when they receive clearly written prescriptions or instructions. Our referrals are also electronic and the turn around time is instantaneous vs. "2 weeks in the mail" so the trade off of less eye contact is fair, according to my patients.
What type of changes do you anticipate for private practice physicians over the next 3-5 years?
Less reimbursement for same services, more e-prescribing mandates to reduce medication errors, and EMR mandates and interconnectivity with hospitals, labs …to reduce medical treatment errors. I hope that an EMR does become available free of charge to connect doctors across the country. Funding is either in the form of advertisements or government monies. I prefer to have no pens, paper products, and toys labeled with pharmaceuticals in exchange for EMR funding from the drug companies.
For solo practitioners, the EMR mandates may be so costly that these doctors may end up being extinct. Perhaps as a larger group the cost reduction will make acquiring and implementing an EMR more a reality.