Friday, February 10, 2012

Why I love my Electronic Medical Record

I love hearing the "controversy" about electronic medical records (EMRs).  There has been resistance from doctors for many reasons. Just last week I read a scathing blog from a doctor about why he dislikes EMRs.  I used to feel the same way, and then...

Let me tell you the tale of my quest for an EMR and the love story that follows.

In 2008 I left a great job at MD Anderson to start my practice.  With nothing but a new Vaio laptop, a stethoscope and a line of credit, I started my business and my medical practice. 

One of my first decisions:  Paper or Plastic?  I decided to get an EMR if I could in any way afford it.  I don't like killing trees, I like being able to access my records from anywhere I can access the internet, and since I had a tabula rasa, I didn't have to worry about converting charts to a new system.

My second decision: which EMR?  I had no cash flow since it takes months to get contracted with insurance companies.  I was doing hospice house calls to pay the bills.  I started a process of reviewing all of the major players.  I looked in vain for pricing on the internet.  I tried to get prices from the vendors.  All of them required an online/phone meeting first so they could show me all of the bells and whistles.  All of them would then drop the bomb about price.  I would try no to gasp or laugh.  They all wanted thousands if not tens of thousands of dollars for the system, PLUS I had to close my office for a week to train my staff, PLUS I had to pay their peeps several hundred dollars a day for the training (with no option for less days of training or no training), PLUS a monthly service fee.  My favorite was the vendor that wanted me to pay for their staff to fly to Houston, put them up in a hotel and feed them, on top of the several hundred dollars a day for training.  After a frustrating summer of these useless calls, I was starting to think, "Man, what have those trees every done for me?  Why not kill a few of them?"

That is when I read about Practice Fusion.  It was in the comments of an article in I believe the NYT, an article about poor adoption of EMRs by physicians.  It said it was FREE.  Well hallelujah!  Where had they been all summer? Apparently they had been there but didn't have millions to spend on advertising their product so I had not heard of them.  I got right online and was up and running by the next day.  I couldn't believe I was getting for free what so many others paid top dollar for.  Sure, it didn't have all the bells and whistles, but there were promises of future noise-making capabilities.

How do they do it?  Well, they have advertisements.  Just like most of the free stuff on the internet, they have ads.  They make their money off of advertising.  Do I have a problem with this?  Heck no!  Just like I don't have a problem with my county and state medical societies making money by selling ads to the very expensive EMR vendors.

In fact, my state medical association was hitting all of the big hospitals and county medical societies to talk about which EMR to choose.  They compared and contrasted the big 5, or what they considered to be the big 5.  I was at one of these meetings and asked why they weren't making physicians aware of the FREE EMR?  Why were they focusing on how to get financing to pay for expensive systems when you could just get a free one?  I received a vague response about only being able to review 5 EMRs.  Several doctors in the audience approached me after to ask about Practice Fusion.  I was a little disgusted with my state medical association.  Then I realized how much money they make in advertising from these big vendors.  Silly me.

We doctors are suspicious folk.  When you tell us something is free, we want to know why.  NOTHING is free.  This is true.  All of those pizza lunches during residency weren't really free.  The price was an in-person advertisement from a drug company.  When you are hungry and have been awake for 36 hours straight, well, give me that pizza!  I asked some fellow docs why they were buying an EMR when they could have one free.  More than one responded that they were worried Practice Fusion might start charging for its services.  Hmmmm.  So they might charge one day so best to go ahead and pay another vendor.  Got it.  Wait, no I don't.

I'll admit I was suspicious too.  I had nothing to lose so I gave it a shot.  Sure enough, over the years, they have added scanned documents, e-prescribing, and even met their promise of "Meaningful Use".  I received my 18k deposit from Medicare a couple of weeks ago.  The support has been awesome.  It only makes sense.  If they make their money off advertising, more users = more money.  Ergo, they are Johnny on the spot when I need them.  The other large EMR vendors really don't have a reason to be responsive.  They have your money and a contract for more of your money.

So am I forcing myself to use something I hate?  Nope.  I love my free EMR.  I see my patients and print out the plan and email the prescriptions to the pharmacy before we leave the room.  At that point, Karla, my lovely assistant, already has a lab slip or card for the specialist I want and the patient gets all of that plus the printed plan.  Talk about convenient and efficient and a great way to keep your day moving.  The majority of refill request come through electronically and click, click I respond.  The majority of labs fall directly into the chart for me to sign off, click.  The majority of other documents are uploaded without ever making paper, from the digital fax service.  I swear I see trees smiling at me some days.

In summary, yes, there can be difficulties with the transition to an EMR.  I have found one with an easy user interface, with wonderful support and it is free.  There is no question that all of our medical records will someday be electronic in some form.  I am just glad that I found the EMR of my dreams before it was too late.  I am glad that innocent trees were not killed in the process.

Lastly, I must tell you that I do have a financial relationship with Practice Fusion.  They give me a free electronic medical record and I just got 18k from Medicare!  Whoopee!  Other than that, they do not buy me pizza or any other meals.  I have 18k to buy them myself.


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  2. Love the last 2 sentences Dr. Blazek, thanks for the support. We love you too! (PS - we have free food and drinks at our user conference in San Francisco every November. Free admission!) - Albert, Practice Fusion account manager

  3. I also was in the delimma of which to choose. I almost pulled the trigger on health fusion but when I found out that it would cost me 600 dollars, I had to laugh. I asked for three free months since they would be getting all of my incentive money over the next few years and they would not accommodate. You mean you want me to adopt and use a program with no test drive? We all get to test drive our new car purchases, right? No thank you and that little area of greed cost you all my stimulus money. I then signed on with practice fusion and while you don't get all the bells an whistles, and they do not help much in getting lab integration, 18,000 dollars in my pocket is worth the minor inconveniences. Folks, give it a test drive. It's a free ride and if you don't like it, just print out all your notes and file them in your charts and you don't loose anything. I'm still printing but very soon, I will be paper free!

  4. Same story, same dilemma, this time for my 2-office, 11-practitioner (from new graduates to old-timers) pediatric group on Chicago's north shore. We've just been using Practice Fusion since October 2011, and we're all-in -- notes, e-Rx, immunizations, growth charts. We're in the process of converting our faxes to email to load them directly into the EMR and we're still using our old billing system for now, but our patients love it, our nurses spend less time chasing down charts and paperwork, we can read each others' notes (hallelujah!), and we have access to our patients' charts at either office and wherever we may find ourselves. AND it's all free! :)

  5. As much as three quarters of hospital staff are usually burdened with some sort of billing-related work in a traditional billing system. Opting for electronic medical billing solutions (ones that come with free EMR plans) that fit easily into the healthcare business' workflow are key to freeing up staff resources.
    Medical billing services

  6. Paper files may be lost in the hospital or in the clinic, but with electronic medical records (EMR), the patient's file is stored in a network and it is organized without a sweat. Oftentimes, due to different illnesses each month or year, the patient visits different doctors. Usually, these doctors don't have time to communicate with each other about the patient, and that's where EMR does its part. You see, there are a lot of advantages with EMR, but the most interesting news these days is that it's one of the major reasons behind the decreasing number of medical errors. EMR is amazing, indeed.

    James Guertin

  7. You’re a definite lucky one! EMR’s should be easy to use, easy to maintain, and easy to repair – regardless if it’s free or not. These factors depend heavily on the provider, so I want to praise you for being diligent on your research (well, that’s something to be expected from a doctor :D). But, it’s also important to note that training on the users’ part is very important to truly reap the benefits of the EMR. :)

    Edwina Andreas