Comments on: Why are doctors such Luddites?

They're quick to embrace new medical technology, but don't ask them to use a computer. CBSNews.com's Charles Cooper explores a generation gap.

[walwebster]

As a veteran nerd who worked deep inside the industry for a long time, and who has raised a couple of doctors, I think I can see both sides of this situation. The article reads to me like a bit of a hissy-fit from an industry that's not seeing the monster returns it expected to fall out of the trees this year from what must be one of the very few bright hopes on the marketeers' horizons.

Suggesting that doctors are Luddites, or that older doctors aren't comfortable with technology, is slanderous stereotyping and panders stupidly to those who think IT was only invented a year or two back when they graduated ...

But while I can assume some degree of medical interest in this article, can I ask doctors -- and perhaps emergency doctors in particular -- to comment on my personal preference [were it yet possible] to carry my own medical records onboard in some kind of an embedment that would be mainly (though perhaps not exclusively) my responsibility to maintain and not some third party's?

I live in Ireland & we have had computerized medical records for years. I even email my prescription refill needs to my GP. Results of all test by consultants are emailed to GPs, even X-Rays & Scans.

I am an American living in Dublin & a diabetic. Dublin has the largest diabetic clinic in the world. It uses retina photography to check the eyes for diabetics & this is Emailed to the GP.

The Medical profession in the US has derided the "Socialised Mediceine" over the years, but I am 80 & have used both systems. Remember this is all FREE for the elderly. My prescriptions are also free & public transportation for the elderly is free. If you are over 75 a companion over 16 can travel free with you.

I think the medical system in the US is the worst in the world!

[df2009]

Discussion about the frustrations and limitations of typing has got me thinking ... what are people's thoughts on the following:


Nothing irritates me more than having to chart details that I know are not medically relevant, but must be in the chart for legal reasons and/or to justify billing practices. It's a waste of everybody's time ... although I can appreciate why it needs to be done. How much more efficient would we be as physicians if all that needed typing in the chart was the diagnosis and important data relevant to treatment and/or follow-up. Charts would contain only relevant information, would be easier to review, query for research, transmit to other healthcare professionals etc...

With the cost of memory dropping so precipitously, audio charting is becoming more and more realistic. If patient encounters were recorded, there would be no need to document details via typing. The audio file could be appended to the encounter and stored securely. Alternatively, speech-to-text applications can produce transcripts to append to the encounter in the chart. Or, as mentioned in earlier entries, a hired staff person can type out a transcript in real time.

The interesting benefits are far-reaching.

- Much more efficient operation for the MD
- Supremely accurate details of the encounter without having to take the extra time typing or writing.
- In medico-legal situations
- eliminates he-said she-said conundrums.
- limits abusive behaviors ... doc-to-patient and patient-to-doc since both parties are aware that their behavior is being documented.
- Eliminates the impersonal 'typing while patient is talking' posture
- Great opportunities for teaching, self-assessment, etc...
- The list goes on...

I recognize that there would be critics and controversies

- privacy issues
- comfort levels with being taped
- patients not consenting to this practice

What are your thoughts...

DF

[BuckinghamCyrkle]

I find it hard to see what all the fuss is about. My HMO (Kaiser Permanente) has had all that information computerized for years. They can access medical records going way back, and there is no problem with prescriptions being illegible or incompatible, it all comes right up. We can email our doctors with questions or make appointments online. I think that if a HMO (which does prefer to be cost-effective) has found this to be a good investment, and they have, it is rather stupid to stick with the old "system" of overstuffed file folders.

[sting7k]

I am surprised at the reluctance of docters to want to use these EMR systems. A friend of mine is just finishing dental school. He is very excited that the dentist he will be working for right out of school just got a new EMR system. The company they got it from even has an iPhone app already in the app store, so if a patient calls him up all he has to do is pull up their charts right on his iPhone.

I've always thought docters were at the forefront of technology. For years going to the hospital with my father (he had problems that are now better) I saw what looked like the coolest stuff. Docters always had 3-4 phones/pagers/gadgets on their belt or were talking about some new instrument or technique.

Now it seems many don't want too see how easy all this could make their lives. No more libraries of files you see behind their counters. No more giving interns mindless tasks to find and re-file patient charts. It's all right there, at any computer or mobile device. Who wouldn't want that?

Our doctor has an EMR. One of the things my wife mentioned to me is that she finds it really annoying that the doctor turns his back to her and our son to frequently to write on his computer. Don't let doctor-patient relationships suffer as a result of going high tech.

[toobluenm]

While I agree that most current EMRs have terrible interfaces and workflows, but I think the most important factor is the setting in which they are deployed- which is all over the place. Requirements are much different in the ER vs the OR vs an outpatient office and both the hardware and software need to be optimized to the setting. I think all the success stories noted above are either (1) in narrow settings where the practitioners get to customize everything to what works well for them or (2) large single payer institutions like Kaiser or the Taiwanese government who can build the entire system (billing, hospitals, physician workflows). - Single payer makes lots of sense and would give us the greater efficiencies overall - but I guess it's too "socialist" for the US.

[lizrobillard]

I just noticed this thread and hope the problem is resolved, if not I was thinking there is software that can handle handwriting, why not attach a little note-pad to the machine to use as a note-pad- lol - I sign my name for delivered goods this way - no reason a doctor couldn't use the same technology to jot brief notes onto? Elizabeth Robillard

[lizrobillard]

I just noticed this thread and hope the problem is resolved, if not I was thinking there is software that can handle handwriting, why not attach a little note-pad to the machine to use as a note-pad- lol - I sign my name for delivered goods this way - no reason a doctor couldn't use the same technology to jot brief notes onto? Elizabeth Robillard