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How some docs feel about EMR......... - Kiki

Posted: Apr 03, 2010

Had an appt with my doctor; she was slowly typing as we talked. I asked her how she liked typing her own records. She said she hates it but has no choice as it is required now. Apparently some companies are telling the hospitals that EMR is required by law. That isn't exactly true, and the companies (such as MQ) do a lot of fibbing and twisting of the truth. While it will be required that medical records be electronic....HOW they get there is where they are fibbing.....an MT can still do exactly what we do now and it can be EMR. The companies are telling them it has to be input by the providers themselves....

Then my doc said she and every other doctor she knows hates it because it takes longer, she can't see as many patients, OR, some docs will cut the visit shorter than they would have in the past. She says a lot of patients seem rightly disturbed by having to wait while the doc clickity clacks away, making rare eye contact bc they are too busy at the computer.........My doc apologized profusely (she prob thought I was just annoyed, didn't tell her I was an MT).....but I didnt' tell her I WASN'T annoyed -- I really was.

My experience with EMR so far - sm

[ In Reply To ..]

1. The first (and only) time my doctor brought the laptop into the exam room and input while I talked, I stopped talking. When he would stop typing and look up and give me his attention, I would resume talking. Back to typing - I stopped talking again. Attention on me - I talk again. He got the hint pretty quickly.

The second time I saw him, he had the MA do the typing while we talked, and that was fine.

The third time, there was no laptop at all .. he was back to listening and taking notes .. and it has been that way since.

2. I have two accounts that have "gone EMR," and they are still dictating. One is Internal Medicine - a PCP who considers himself "the gatekeeper" and whose Initial Visit H&Ps and Comprehensive Physical Exams are 3 - 6 pages long. He says there is no EMR program in the world that would include all the information he requires in his records, and present it in the way he wants it.

The other is a specialist who, with every visit, dictates a letter, 1-2 pages long, to the referring summarizing the visit into sections of HPI, Exam, and Plan/Recommendations. He prefers that personal aspect between himself and the referring doc.

These two doctors are doing what they have to in order to comply with EMR regulations, and they are still dictating so they will have complete and comprehensible records.

* Three other accounts have not even touched EMR yet. When they do, I will be using the above two examples as to why they should consider retaining supplemental dictation/transcription in their practices.

I do the same....typing....I stop talking or I scootch over - Kiki

[ In Reply To ..]
right next to the doc and look over their shoulder while they type.

I'm just saying it stinks that the EMR companies, such as MQ as well as others, are feeling a line of outright lies to any hospital who will listen, making them think they are required by law to type their own reports.

you, looking over her "shoulder" when your doctor is working, - scootch over?

[ In Reply To ..]
will make her nervous and might cause errors.
Who wants to be looked over one's shoulder when working.
Very inappropriate behavior in a doctor's clinic.

Another doctor would have told you.."You make me extremely nervous, you might look for another doctor!"

Well..........to that I say..... - Kiki

[ In Reply To ..]
If she's gonna get "nervous" with me just looking at my own report, I DO want another doctor. She wasn't at all, in fact, like I said, she turned the monitor towards me, pointing things out as we went along.....she ADMITTED she hated that it took so long, too.

Remember this was MY record, not someone else's. If she would have said she felt uncomfortable I would not have done it....she was inviting.....

I am sure that dictating your report takes longer. Docs HATE to dictate reports - emr or dictate

[ In Reply To ..]
They dislike dictation and they dislike also EMR, to date, because who likes to do something one is not good at.
They will get better.

I am sure that when doctors get used to emr they will prefer it over dictating reports.
EMR will be the faster and cheaper way.

EMR, done by docs, will be the solution for the efficient and disappointing VR we MTs are so much complaining about, and straight transcription has become much too expensive for the clients.

should read".... "inefficient" and disappointing VR..... - vr

[ In Reply To ..]
nm

EMR - Anonymous

[ In Reply To ..]
My place is going to Epic in about a year. The docs have been given the choice of entering patient information into templates, dictating into VR and doing their own editing or straight dictation. I agree that they will still need to retain supplemental dictation and transcription. We'll have a smaller MT department but some MTs will still be needed.

so, did you tell your doc it is not exactly true? - n/m

[ In Reply To ..]
..

I did. My sister works as a hospital administrator. But she just - Kiki

[ In Reply To ..]
just said, "really?" and that's about it. Shrugged her shoulders bc I think she thought there is nothing she could about it if it were true.

Really? Are patients in your "sister's hospital" allowed to read docs' charts an - Really x2 ?

[ In Reply To ..]

I would call this overstepping one's line, that's what you, Kiki, are doing "scootching over to your doc's computer doing EMR."

"Doc, let me QA, what you are doing here, you know, I'm an MT, I am better than you!"
Ridiculous!

Your are the ridiculous one....my doc didn't even - Kiki

[ In Reply To ..]
know I was an MT. I wasn't making comments, just looking. And as I said turned it so I could see it, pointing things out to me.... It was MY record! Not someone else's...maybe you should READ posts before you reply

that shows only that YOUR doc is not computer savvy, - emr

[ In Reply To ..]
there are doctors, especially the young ones, that are embracing EMR since they are using computer already for yyyeeeaaarrrsss!

Also ESLs (by MTs called "mushmouths, marble mouths, etc...) who are computer savvy - there are a lot of those, believe it or not ! - will welcome EMR, and also MTs being "relieved" from their inaudible dictations, don't you agree?

Your doc needs to take a computer course. How old is she?

She's actually fairly young, late 30s/early 40s... - Kiki

[ In Reply To ..]
same as me....

I do know she is going to have to get used to it. This whole thread started with me just saying I was annoyed that the EMR companies were lying to a lot of doctors saying EMR was MANDATORY and that they had to enter info themselves when it isn't (yet anyway).

in some way the government is sponsoring EMR - emr

[ In Reply To ..]
since the gov is giving subsidies to hospitals that introduce EMR, and also regarding Medicare.

docs are all new at this, they'll learn. How were you doing when you were a newbie? - sm

[ In Reply To ..]
If I were your doctor, I would tell you.......

"Please stand over THERE and do not look over my shoulder!"

Refusing to answer the doc's questions will certainly NOT eliminate EMR, it's childish behavior.

I don't see it that way at ALL. After all, it's MY - Kiki

[ In Reply To ..]
medical records I'm looking at. She had no problem with my doing it, either. She even turned the screen for me. If I wanted to, I could order my entire record and take it home.

As for being childish, don't agree there either. I never "refused" to answer. I'm not folding my arms and refusing. Just waiting for her to get done and make eye contact. Also, SHE apologized to ME for the typing taking so long, as she was a hunt and peck typer.

were you putting your nose into a doc's medical practice - emr

[ In Reply To ..]
before they started doing EMR?
Were you checking if they read x-rays, echo, MRI the 'right" way and were error free?

Just because you are an MT does NOT give you the right to 'QAing" their work.

This is just ridiculous behavior and your doctor is being very polite. This only until they "get" it, then no doctor will tolerate your behavior.

Gagging over response - MTgagging

[ In Reply To ..]
Give it up...she can look at anything the doc is typing that applies to her. Get over yourself. Stop taking everything so seriously.

I see...YOU certainly do not take anything seriously, it's not a rodeo! - OMG

[ In Reply To ..]
nm

hahahahaha, you are so wrong, there are rules, ya know! - lol

[ In Reply To ..]
nm

eeeewwww, your reply makes me gag - ???

[ In Reply To ..]
nm

THANK YOU! Finally a voice of reason! n/m - Kiki

[ In Reply To ..]
x

this was my response to MTgagging. I am not rallying for you, Kiki - pro emr

[ In Reply To ..]
nm

I agree with you Kiki! - Ignore these fools

[ In Reply To ..]
they certainly cannot read, because you never said that you QA'd the docs work.

Unbelievable. Some people will do anything to argue.

..and OP wants to convince everybody that EMR is no good - emr

[ In Reply To ..]
What about the so many complaints by MTs how horrible VR turned out to be?

Well, therefore IT people invented EMR, maybe this will put a stop to the complaining by MTs.

But obviously, also this version of medical reporting is a reason to complain by MTs.

Yes, this person sounds as if he/she is very much against the MT. - anon

[ In Reply To ..]
Does not sound like an MT, wonder who they really are? MTSO, mgmt?

....again this "assumptions." I am a"realistic, proactive" MT - omg

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Do you really think that hiding your head in the sand rendering you blind, is going to help you?

Take off your blinders and accept change:

1. straight transcription is out
2. VR did not hold what what was promised
3. EMR is the new technology. IT experts are working on it.

At my age, my head is not in the sand. Someone - anony

[ In Reply To ..]
states what they feel, how they deal with something, and someone has to come along and give them a lecture as to why they are wrong (in your opinion, doesn't make them wrong.) No blinders on here and have accepted change until it is "coming out of my ears." Kiki is entitled to do things her way without being told she is wrong.

looking over the docs' shoulders at their screens doing EMR? - allowed?

[ In Reply To ..]
nm

That would be between her and her doctor, but she - anony

[ In Reply To ..]
still should be able to express her feelings without being scolded.

same applies to me, I can post my point of view, w/o being insulted - same

[ In Reply To ..]
nm

Nobody insulted you. - anon

[ In Reply To ..]
n/m

are you confused? Sure they did, e.g. MTgagging did w/her comment: - see inside

[ In Reply To ..]
Gagging over response - MTgagging (Views: 88, 2010-04-04, 1:57 pm)

Give it up...she can look at anything the doc is typing that applies to her. Get over yourself. Stop taking everything so seriously.

----

No, she cannot look at everything a doctor types in his clinic, even if it's her report. She cannot say, "Doc, let me look and see, geeezzz, what are you typing here...?"
She can ask for a transcript, later.

This comment is so irate and unprofessional, and additional she mentions:

"Give it up, get over yourself, stop taking everything so seriously?"

What a weird post.

You are obviously not an MT! - anon

[ In Reply To ..]
n/m

I am an MT, but one that is not blind and is accepting chance - change is inevitable, everywhere

[ In Reply To ..]
nm

Everybody else is accepting change too, since there - anon

[ In Reply To ..]
is no choice. That doesn't mean they have to like it, or that it is necessarily change for the better.

I agree, it is not good for MTs. But we have to - new tech

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realize that docs also need a learning curve to get better.

We cannot block new technology coming also into our field by resisting it, but we should, if we want to stay in this field, research what jobs are created and offered by the introduction of this new technology.

Lordy, I give up. No use explaining that i was NOT trying QA anything..... - Kiki

[ In Reply To ..]
f

what were you then trying to do? According to your OP - even worse

[ In Reply To ..]
yuou wanted to convey to all readers that ALL doctors find EMR a disaster and do not want to have anything to do with it.

Was this what you wanted to project? Yes, it was.

But you are wrong.

EMR is the future MTing technology.

Maybe not for the elderly docs, but certainly for the young ones who use computer already for 20 years.

You certainly cannot hold up new technology by pointing out that "some" docs have difficulties mastering it.

It isn't the same thing but - Badcat

[ In Reply To ..]
It isn't the same thing, but often I too have demanded to see my own medical records, and sometimes of my family members. I want to see them for myself and make sure they are telling me everything. Give you an example. When my mom went in to have a hip replacement after falling, they told me they had her on all of her medications. So I asked to see her chart and saw they did NOT have her on her Xanax, which she took on a regular basis.

And when she was diagnosed with terminal cancer I asked to see her records too, because all they said was "terminal", they didn't go into detail. When I saw the records and saw the spread I was able to tell both my brother and sister that there was no hope.

I don't think it's wrong at all to be able to see your own records, and if you are an MT you have an advantage in that you can understand the terminology, and you know a little more about what is going on, because there are some doctors (not a lot but some) who won't tell you everything.

read the OP's first post that started this thread... - EMR is the issue

[ In Reply To ..]
"How doctors feel about EMR"." It started out how doctors feel about the implementation of EMR and the OP's behavior (scootch over) in the doc's clinic, not about the right of a patient to get a copy of her record.

EMR is the issue of THIS thread which was then sidetracked.

If you "order" a transcript of your report, don't you have to pay for it? - doc doing emr

[ In Reply To ..]
BTW, this is something else than "looking" a doc over the shoulder. You are not allowed to step around in a clinic wherever you want to, there are places that are off limits.

I doubt that persons who are not MTs dare to behave like you do and take their position beside a doc doing EMR. Are you above the crowd?

Might have to pay, but it's only for printing/paper, that's all. And - Kiki

[ In Reply To ..]
I'm not "stepping around in a clinic" -- I am sitting 2 feet from the doctor and can see the screen w/o even getting off my ****. I'm getting sick of people just replying w/o reading the entire thread. This isn't even where this was supposed to be going. Jeesh.

*** Leave out language, period. ****

EMR bringing my own history - planetspinz

[ In Reply To ..]
I bring in a typed history and review of systems. I list my medications. If I am going to a new doctor, I type up my family history, past medical & surgical history. I pretty much give them everything but the physical and labs. I tell them what I do for a living. Then instead of the doctor typing, they glance at the paper I gave them, take it to their secretary and have them type it up. It's pretty much in their EMR format. This way I know it's accurate (until I get home and remember what I forgot to type up).

Is this legal? Is a doc allowed to put data that you bring into HIS computer, possibly with errors? - huh? wao!

[ In Reply To ..]
nm

Yea, they use that every time you come in and charge a higher level code for your visit - BUNION

[ In Reply To ..]
Whether it is right or wrong, where as Kiki, I would like to check mine for accuracy, (who put it in there?) Then doc's take a glance and charge you up a notch as they (read it) hahaha. CRAP Right or wrong they say the read it and now it is a 99214 or 99215, more money for (your)insurance company to pay them. This just kills me!!! They glance and can pull it in their report, hahaha, same thing, every visit, right or wrong. Go Kiki for looking at your personal record. I will also, as that is what we are getting now, a doc at the puter and very little hands on. Such a sad twist here. Get it now kids?

??????? - huh?

[ In Reply To ..]
nm

the thread is about EMR, yes or no - what?

[ In Reply To ..]
nm

you are there as a patient, not as an MT - huh?

[ In Reply To ..]
nm

not "some," "your" doc...don't speak for all doc - nm

[ In Reply To ..]
nm

When I go to a doctor, I do not expect "eye contact." - diagnosis & treatment

[ In Reply To ..]
I expect a correct diagnosis and the correct treatment.

I do not care if he looks at me or not. Do you?

I also do not care if he calls me 'honey' or "sweetie," or things like that. Do you?

Is this a time for endearment?

it takes longer and she can see less patients - docs & emr

[ In Reply To ..]
because she is too slow, not fast enough.

Now EMR diverts the production pressure to the docs.

Now they will "feel" what they put us through with their horrible dictations.

They will get better and stop complaining.

the companies are not telling the client that EMR - incorrect post

[ In Reply To ..]
is mandatory, rather the EMR software vendors.

Why would the doctors apologize for using EMR, slowing down the reporting because they are still in a learning curve, if it is mandatory by law?

????

is it really MQ? OP states in her post...sm - where is the logic?

[ In Reply To ..]
"...Apparently some companies are telling the hospitals that EMR is required by law..."

Why would an MTSO do that?

Apparently you do not understand,. till now, that the implementation of EMR where docs enter their findings into templates and little VR is left, will eliminate MTs AND MTSOs to a rather large degree.

Do not blame MQ for everything bad that happens to MTs, but research what EMR is all about.

The ones who push the EMR issue are the EMR software vendors and to a certain degree the government.

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