Welcome to EMR and HIPAA

I’m sad that I didn’t see this list until now. Mike Gleason provides an interesting list of reasons why small practices aren’t implementing an EHR as fast as we’d like them to implement. Here’s his list of 10 reasons:

Fear
Ego
Money
War Stories
No one wants to go first
Product not perfected yet
Waiting on Govt mandates
Waiting on hospital install or Stark gift
I have people for that
Change

A really great list. Mike also discusses each of these points. As time permits I’d love to take some of his points and write some comments on each.

More important for this post, I wondered what other reasons might be missing from this list. Here’s a few others that I came up with:

I’m retiring soon
I don’t like computers (similar to “Computers Scare Me”)
Procastination/Lazy
Commitment problems (can’t decide on which EHR system)

Those last couple sound a lot like why many people don’t get married. Pretty interesting since I’ve compared implementing an EMR to marriage multiple times. Any other reasons for not implementing an EMR that we’ve missed?

Today, I decided to start a new web page that I believe will really grow over time. It’s basically a list of the possible benefits a doctor or clinic can receive from using an EMR or EHR rather than paper charts.

I haven’t take much time to make the list at all, but I think it’s better to start it and then as ideas come to my head I can add to it as time permits. I already have a number of other ideas (like quality of medical care), but I need some more free time to put all the details down. Now that I’m thinking about it a little bit more, maybe each benefit of an EMR should have it’s very own blog post describing the benefit that’s received by using EMR. We’ll see how that works. Seems like a worthwhile series of posts to me.

Also, in all fairness I’m certain that I’ll also soon be creating a list of problems associated with EMR. I think it’s important to keep the discussion well rounded and that people are well aware of both the benefits and challenges associated with using an EMR.

Finally, I certainly welcome comments from people on benefits or challenges associated with use of an EMR. I look forward to hearing ideas from other people’s experience to help me round out the list of benefits and challenges that many have already experienced first hand. Might as well try to pass on that knowledge to those who are still implementing or looking to implement.

I’m currently attending the PCCHA conference which is basically the college health association conference for the west coast. The conference has been quite interesting. A few of the sessions ended up being quite useful, but more than anything it was just fun for me to talk to all of the various people working in the college health community. Most of my conversations centered around EHR and EMR implementation, but it was also fun to see these other college health professionals jealous of the really state of the art facilities we have on our campus.

My presentation on EMR went quite well and I think that many of the people in the audience got some useful information. At least that’s my hope. It was fun to present on EMR and the things we’ve learned. The interesting thing for me was that as I talked to people about EMR and EHR and using it in college health, I realized that over the past two years I’ve really learned a lot about what it takes to implement an EHR into a clinic. It can certainly be a daunting task if you look at all the intricacies.

In the end, my message to most of the people that I talked to was that while implementing an EHR can be overwhelming, it’s important to take small bite size pieces of it and accomplish those. Then, move on to the next problem and the next. The reality is that 2.5 years after implementing our EMR system, we’re still adding, modifying and changing our processes to be more effective.

I did a presentation recently on an organization’s resistance to change and the effect that has on software implementation. An EHR implementation is definitely no exception. In fact, it seems that many doctors are even more resistant to change than other industries, which is why we have the roughly 10% EHR and EMR adoption rate.

In my presentation I found two images that described the challenge of adopting an EHR and resisting change very well.

Does this remind you of discussing implementation of an EHR?

This one is a great one, but might take a second to truly understand.

Did you notice the wheels in the wagon? Seems a bit like a $60,000 EHR system sitting on the shelf to me.