Saturday, January 3, 2015

We're Not in Kansas Anymore, Toto

From Kaitlinwatteron.com
I was just thinking, now that the New Year is fully upon us, how things have changed ever so 'slightly' in our practice, and likely yours over the past year.

In fact, looking back over just the past couple of years, it seems like the changes are many and significant, and there is seemingly no end in sight now that we have started down this path.  Are the changes accelerating, or is it me that is stuck in my ways, already looking back to my 'glory days' despite my age only still in my forties?

Oh, some of these changes are certainly for the best.  Some are meant to be for the best, but fall notably short. And some... I have no idea.  In fact, their very name or label for a new part of the medical practice sometimes couldn't be farther from the truth. Does the term "Meaningful use" sound familiar?

So here is a list, in no special order of a few of the changes that have entered our practice, and your as well, and are now part of the current state of Electronic Medicine as we all are well into this next generational phase.

The Electronic Medical Record. A topic of topics unto itself.

Istop.

E-Prescribing for most meds, soon to be all meds in NYS.

Sorian Clinicals (clinical platform) and Sorian Financials(billing and scheduling platform).

Computer Physician Order Entry.

HIXNY.

Patient Portals.

E-Discharge orders in addition to order entry.

Meaningful Use with regular updates of new mandates required every quarter.

This list is a bit more daunting than it may appear.  And yes, all do bring a new level of potential benefit to the general care of a patient by a provider, but the pace of the new rollouts, and the often additional skill set development required to manage each "App", and that aspect itself for me leads to instantly less user-friendliness than intended.

Add to that the often non-interactive nature of these individual Apps, that in a perfect world should work together in compatibility, and do not. Such as in our system, our Sorian Financials that didn't play nice with our EMR platform.  Or the hospital side of diagnostic tests and reports and hospital admission data that again doesn't easily flow to the EMR platform, thus requiring manual 'scanning in' to make the EMR useful and approaching the completeness and usability that I think the database was intended to provide.

And, those "Meaningful Use" criteria that appear to be progressively nickel and diming their way to more irrelevance as they additively take more and more time to process a patient visit, for often no perceptibly added gain in quality to an office visit.

But in summation, probably the most substantial negative common denominator for all these additions to our medical system in the recent past is more Time.

Time - a commodity that was short to begin with, and now so much less is available to maintain anywhere close to the productivity that was once a sense of pride and purpose in how I approached my day, every day.  Not just to maintain financial stability for an employer, but the ever-present challenge to maintain a personal standard of high quality, efficiency, and personal connectedness to each patient I see. That's much more difficult now, even that the learning curve for our EMR, for example, is nearing its 1 year mark.

What I still have hope in, is that somehow we will acclimate, and we all will be soon getting back to a sense of what it means to truly participate in the care of a patient, and that these new tools, and even those that are mandated to be used, can be put together to comprehensively offer true advantage to us as providers, and the patient-provider relationship,  actively taking advantage of newly available technological means.  That's what Meaningful Use would mean to me.

Because, what I am discovering, as I look at a printout of 2-3 pages for a follow up office visit with all sorts of "meaningful" information - is that which is often the first casualty to save time with these new modern era office visits of checking all the boxes on all the necessary components of the visit - is the connectedness that I so enjoyed with how medicine was in the past.  "Medicine" as a whole is now not the same as it once was.  Not by a long shot. I miss Kansas.  And, (Toto) I miss the Rain down in Africa...

And you know what? Even worse?  Providers aren't the only ones who are a bit taken aback by this new electronic era of medicine. Patients have noticed as well, and some of them are not too happy either with the change.

So, enough ranting already.  Back to Bariatric issues and insights soon!

Happy New Year.

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