There are multiple reasons to use an EMR.
I jumped to it 9 years ago because I wanted to have a better way to chart and saw this as a good affordable solution.
It seriously helped be go from what I will admit was lousy charting to very good charting without a lot of effort (to chart.) Of course, I had to install the computer systems and such but that was part of the fun as well.
That was long before much of the Quality Measures were developed for medicine, and they have been useful in codifying what is proven good from what is perceived in medical care.
That was long before the government jumped in and started CCHIT or Stimulus money.
Now the push is on money. That is a lofty goal.
I am a Pediatrician (one of the lowest paid physicians) who see's predominately Public Aid (one of the lowest payors) in Illinois (one the lower paying Medicaid states) and I make it work.
My computers are refurbs but they get the job done. I would like to upgrade my computers. I would like to give my staff a bonus for working hard. Stimulus "promises" that. I WILL qualify but we have a government that may not even be able to pay it's own bills on Saturday. I will believe it when the check clears the bank!
In the mean time, I try to provide the highest quality care that I can. AC helps me do that. Are there things that can be done to make AC better? OH YEAH. I am MUCH more confident they will happen (eventually) than I will see Meaningful Money for Meaningful Use.
BTW Version 5 does not have codified smoking, race and language preference. Obviously the staff at AC was seriously deficient in not including these YEARS ago since they are so critical to patient care (OK, smoking maybe but for Peds it becomes a joke to see the box for a 1 year old. Might be nice to have it converted to family smoking though)
Everyone expects something different out the program. The early adopters were much more computer savvy than many of the newer persons who bought the program because of the "rush" to get something for stimulus money.
Many early adopters could care less about stimulus or many of the government mandates because we saw how efficient and smooth the program was before these hoops were made to jump through and we also saw that relevent changes that would have been made on a timely manner were now put on the back burner because of the chase to get certified (either CCHIT or MU.)
This is not to knock those goals. As a former PHO and multispecialty Medical Director, I can appreciate the both the goals and direction of Health Maintanance sections. I am not crazy about the execution but it is OK. Orders is a different matter. I think it was better but it was changed to make it "codified" that could be tracked better. While this is good so that you do not miss labs and such the execution was suboptimal.
I have, over the years kept lists of things I thought were wrong from the program. Many, if not most, of the things were extracted from this board. I have shared these lists a number of times, but what I am most impressed with is HOW MANY things on the lists ARE CORRECTED. Some of them are version specific, some of them are long standing. But we DO move forward despite the pulls in various ways.
Anyway, I have been rambling long enough.
