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Major Health Organization Stops Forcing Doctors To Adopt New Technology (internalmedicinenews.com)
nbauman writes: The administrator of the Centers for Medicare & Medicaid Services, told an investors' conference that they will be backing off the unpopular requirement that doctors show "meaningful use" of their new computer systems. Andy Slavitt, acting administrator, admitted that "physician burden and frustration levels are real. Programs that are designed to improve often distract. Done poorly, measures are divorced from how physicians practice and add to the cynicism that the people who build these programs just don't get it."
Dr. James L. Madara, CEO of the American Medical Association, agreed that EHRs were having a negative impact on physicians' practices. Many physicians are spending at least two hours each workday using their EHR and may click up to 4,000 times per 8-hour shift, he said. Instead, CMS will reward health care providers for patient outcomes through the merit-based incentive pay systems created by last year's Medicare Access and CHIP Reauthorization Act (MACRA) legislation.CMS is calling on the private sector to create apps and analytic tools that will keep data secure while fostering true and widespread interoperability.
Dr. James L. Madara, CEO of the American Medical Association, agreed that EHRs were having a negative impact on physicians' practices. Many physicians are spending at least two hours each workday using their EHR and may click up to 4,000 times per 8-hour shift, he said. Instead, CMS will reward health care providers for patient outcomes through the merit-based incentive pay systems created by last year's Medicare Access and CHIP Reauthorization Act (MACRA) legislation.CMS is calling on the private sector to create apps and analytic tools that will keep data secure while fostering true and widespread interoperability.
One of the major problems is people think doctors are just doing checklists, but most of what they do is observe. You're not observing while you're fiddling with your tablet and looking away from the patient. Strangely, having paper is less of a distraction.
Also, it can create HIPPA security issues.
-- Tigger warning: This post may contain tiggers! --
The state university health system that most of my doctors belong to started using EHR software in earnest about 6 or 7 years ago. It amazes me that the designers and developers of EHR software seem like they design stuff that's intentionally frustrating to use. I've seen worse UIs, but they tend to be for things like buzzword-compliant ITIL based service desk ticketing software, or things that are so proprietary that a functional GUI is not something the customers will pay for. Every time I've gone for an appointment, especially when I'm a new patient (even within the same health system,) the first 10 minutes of the appointment is a frustrated doctor asking question after question, followed by 6 keystrokes, 20 clicks, dropdown here, expand button there, etc. etc. etc. It's as if an offshore code factory was handed a spec, coded exactly to that, and no integration work was done to ensure it would be usable -- and I wouldn't be surprised if that was the case. You might say doctors are a pampered, privileged class who are used to having nurses and medical assistants to do all the "work" but from what I've seen the software is a mess. My dermatologist gave me a "tour" when he found out I was an IT guy -- if I were a doctor I'd be running back to the paper charts in a flash.
Contrast this with the industry I work in -- airlines. Yes, it's old, proprietary, ancient, slow dinosaur technology.at the core, but the GUIs are designed for maximum throughput. An experienced reservation agent can do a booking in under a minute without taking their hands off the keyboard, and everything in the application is actually designed to minimize cognitive load. As an example, I've never worked behind the counter on real passengers, but I can sit down in front of the GUI and understand the flow, look stuff up, etc. That's because the reservation system companies do actual time-and-motion studies and watch real people use the product. I highly doubt the EHR companies do this, nor do they have anyone on staff who uses their software regularly.
Yep, I spent all summer of 2013, and I mean all summer, trying to beat our POS EHR into some semblance of utility. It was a total failure and it looks like I will be spending the entire summer of 2016 trying to figure out how we disentangle ourselves from this mess. A complete was of a lot of time and money that could have been spent doing something useful.
And "Meaningful Use" was a big part of the reason that our vendor screwed the pooch. It wasn;t a very good system to begin with (Healthland Centriq), had been developed before Meaningful Use was a gleam in the committee's eye and the vendor spent precious (well, cheap Indian) developer hours trying to shoehorn MU requirements into the system instead of getting it to just work. And that little game was repeated all over the country.
Faster! Faster! Faster would be better!