Monday, May 20, 2013

Electronic Health Record challenges . . .

One of the challenges of using an electronic health record (EHR) is that of communication and order generation with ancillary services.  Medicare has mandated conversion to the use of electronic prescribing and commercial insurance has followed suit. The challenge is that as we are all becoming more paperless, ancillary services are no longer accepting prescriptions that don't have an "actual signature".  Medicare as also mandated that every order be "physically signed" which is becoming impossible with use of EHR.
This hasn't posed a problem with Medicare or with the commercial insurances, but it has begun to drive a wedge between the patient and his or her physician. We send a prescription electronically and the ancillary service kicks it back because it isn't "actually signed on paper."  Patient's feel our office is not doing its job correctly because the ancillary services told him that he "orders were signed correctly."  We are doing our job and having to duplicate services.  Everyone gets irritated all the way around the process.
Because we as a society are used to getting "our burger our our way" within a two-and-a-half minute window, my staff frequently gets an ear-full. Screaming and cursing at the doctor's office staff is not the way to get things done or aid your cause.
The burden that is created by the mandate for EHR use causes a significant change in the office flow.  It takes a good 6-12 months for a physician's to improve efficiency when the whole office flow changes.  My office is not alone in this problem.  We just recently changed our electronic health care record and significant process changes were made which has caused us delay and efficiency drops while we accommodate the new flows and attempt to write orders that were signed with electronic signatures with "actual wet signatures."
I have been using electronic health records for over 11 years.  The process isn't getting any easier, unfortunately. If you are a patient, or an ancillary service, please be patient with your doctor's office.  We are becoming as regulated as the airlines . . . who knows  . . . you may soon need to pass through a TSA scanner before you can enter my office.  Wouldn't that be exciting?!

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