Finding meaning in meaningful use


A few weeks ago we pointed to the musings of one early EHR adopter who was doing some serious re-thinking about his early enthusiasm for the technology.

In our view, it speaks to the good doctor’s integrity that he didn’t finish his thoughts on a negative note; he’s back now with his own wish list for what would give real meaning to EHRs moving forward.

We’ll leave it to you to add to or quibble with his entire list, but a few complaints (as he explains his recommendations) seem worth highlighting, in a stream of consciousness sort of way.

To wit: “One of the biggest problems I have with EMR is the ‘data diarrhea’ it creates, throwing piles of words into notes that is not useful for anything but assuring compliance with billing codes…Related to #1 would be the ability to hide as much “fluff” in notes as possible. I only care about the review of systems and a repetition of past histories 1 out of 100 times. Most of the time I am only interested in the history of the present illness, pertinent physical findings and the plan generated from any given encounter. The rest of the note (which is about 75 percent of the words used) should be hidden, accessed only if needed…I spend huge amounts of time searching for answers to questions like: 'were they ever on drug x,' or 'when was their last y procedure?' I would love to be able to do a ctrl-f (or cmd-f) search on patient charts to get that information.”

What strikes us about most of his complaints and proposed solutions is how, not surprisingly, they’re essentially primary user related. That is, they speak to the complaints and preferences of a doctor, and doctors, after all, are the primary users of EHRs.

This, in turn, leads us to wonder if part of the problem, real or perceived, with the meaningful use regs is that they’re designed to be followed by doctors using EHRs, but the goals, and the resulting required use, incorporate much more into the equation than just one doctor helping one patient.

Even that sentence was complicated, so how much more complicated must the situation really be?

At any rate, check out his checklist, and add or subtract as you wish. Perhaps a vendor or two will look at it and see an opportunity.