Our Electronic Health Records . . . You Love Them and Hate Them

Once again I want to apologize for our office being hard to reach this week. After being closed for 10 days, while I attended and presented at the International Headache Congress, the second day back our electronic environment collapsed.  We could not access our electronic health records or our messages.  It does appear that the system is back up and running.  I personally still cannot retrieve messages as we are closed today due to the 4th and Kaaren is not available and she has the messages secured by her own password.

It is regrettable that this happens.  I do want our patients to know that when I opened this office I did everything I could to avoid such events. We purchased the best computers money can buy. We got the most dependable Internet provider in our area.  We bought the best computer-based phone system that money can buy.

One of the problems is related to the HITECH bill, which is part of Obama care.  It requires practices to use electronic health records. That is fine, but the problem is, the US government has only certified certain EHR vendors (I’m sure those with the best lobbyists).  Before Obama care, I had an excellent EHR, but, because I had created it myself, it was not certified by the government nor could it be. So we actually had to downgrade to a much worse system, but one that government approves.

I am presently working tirelessly on a new system that will be much better, that will not require to sit and type while I’m with patients.  I hate doing typing. I will blend this much better system with the government approved system so that we still meet federal guidelines.

I presented a study at the International Headache Congress showing that we have achieved the highest patient satisfaction level ever recorded by a headache clinic, near 97%. We are different. However, even we do get hate-mail from patients occasionally. I had a patient recently send an anonymous note that they are offended by my typing during appointments and it proves that I don’t really care about her.  I take this very personally and that really hurts because I can’t imagine how any human on this earth could care more about their patients than I do. My entire life revolves around me trying to do everything in my power to help patients get better.

She commented in her letter that her other providers don’t sit and type while they visit with her.  I will explain several reasons why that may be true.

If the practice she is referring to is part of a major group, which most practices are these days, they have an abundant of resources, which we don’t have.  They have an EHR that cost them hundreds of thousands of dollars. They also have a team of IT people that keeps it running perfectly.  They also have transcriptionists.  Lastly, most providers don’t get into as much detail as we do with the major problems.

While being part of a large system would solve many of our EHR problems it would come at a great cost to our patients. The way that we practice headache medicine is very inefficient when it comes to money. We spent a lot of time with our patients, most of which the insurance companies never pay us. The big systems would not want us because we don’t make a lot of money. Secondly, if they did buy us out, they would immediately mandate their culture of medical care.  No big system understands headache disorders and they are universally trivialized by them.  At the meeting I spoke to several headache specialists at major institutions.  They headache programs are being cut and eliminated because they don’t generate a lot of revenue. That is why we see ourselves as a patient-based center. That is what we eat and breathe.

So, please be patient with us and our EHR.  When my new system is running I hope that the notes are much better and requires much less typing and are available even with a major electronic collapse.  If there is ever anything you don’t like about the way we do things, please ask me about it . . . but please never, ever accuse me of not caring about you.

J. Michael Jones, MPAS-C