Re: Walmart Health: Just had a great dental visit this morning, which was preceded by helpful reminders from Epic, and…
Intelligent Healthcare Information Integration 1/20/10
Blowin’ in the Wind
I know it’s not just me. If you’ve read through the recent series “EMR Vendor Executives on Meaningful Use and Certification Requirements” here on HIStalk Practice, you know not everyone agrees that the “Meaningful Use” criteria (MUC) are all roses and rainbows.
Still, it feels as if the voices which ring most true to my trench-weary ears are not the ones being heard most loudly nor echoed most frequently. Most of the big brains of the industry, be they governmental guiders or corporate cognoscenti, seem to be enraptured with the power and the glory of the MUC. Me? I’m feeling more mired in it.
Don’t get me wrong: I wanna believe, believe me. I want to feel that my medical cohorts here in the trenches really can absorb the MUC, all 700 pages or so. I want to have faith that my fellow EPs (Eligible Professionals) have more time in a day than do I in order for them to adjust all of their long-ingrained work habits and processes while still seeing all the folks who need care. I want to have the confident sleep of the assured who know that meeting regulatory demands won’t hinder their ability to meet next week’s payroll, shortchange their doctor-patient face time, nor further diminish their familial familiarity. (Remember me, son?)
I also want to believe that the big brains in the big places have the best interest of all of us at heart. I know most of them come from bigger centers, have bigger educations, and often have bigger bank accounts than many of us middle America minor leaguers. I want to believe that we matter to them and that they understand that the majority of healthcare in the U.S. is provided by smaller players who have no I.T. team, who have techno-illiterati-filled staffs, and who really want to focus on doing what’s right for our patients, not our data centers.
People like Evan Steele of SRSsoft brighten my outlook, but not because he is an exquisitely optimistic and rosy-glassed opinionator. Rather, his bold honesty and willingness to sound un-salesperson-y are what make him one of my current mini-heroes. He expresses an understanding of the enormous workflow issues entailed within the MUC. His forthright skepticism about the abilities of me and my trenchmates to be able to shovel sufficient MUC to be able to keep our heads above it are spot on, at least from the view down here. (See his comments in Part 2 and Part 3 of the series.) Evan has been particularly impressive in his understanding of us grunts … a tip of my MUC-covered helmet to you, sir.
For now, though, I watch and listen. The breezes seem to be bringing sounds of big institutional choirs and big center songs with very few micro-doc choruses. I try to raise my voice, but the MUC seems to be a bit thick down here.
From the trenches…
“The men with the muck-rake are often indispensable to the well-being of society, but only if they know when to stop raking the muck.” – Teddy Roosevelt
Dr. Gregg Alexander is a grunt-in-the-trenches pediatrician and geek. His personal manifesto home page…er..blog…yeh, that’s it, his blog – and he – can be reached throughhttp://madisonpediatric.com or doc@madisonpediatric.com.
I’m sure Gregg understands that Evan Steele is taking a contrarian position re EHRs because his product supports the ongoing use of paper as the MD’s primary tool for interacting with an “electronic” health record. Will that get us to interoperability and meaningful exchange of clinical data among providers and with patients? Hard to see how those dots connect!
Cowgirl, I think Evan’s years (nearly a decade) helping run his brother’s pediatric ophthalmology practice helped him understand that operations and workflow are, at best, difficult to manage optimally for any physician. Be it PDF/H or any other interim step toward helping clinicians move toward digital data management while maintaining daily operations (i.e., seeing the volume of patients necessary,) I’m a fan.
Being a doc is tough enough these days. Adding a complete workflow overhaul onto my less geek-oriented colleagues’ To Do lists seems counterintuitive. Helping them take steps in the right direction, even if not as fully byte-based as I’d prefer, seems much more likely to eventually achieve the end goals of interoperability and meaningful exchange of clinical data you and I both desire.