Mining Malpractice Data to Make Healthcare Safer, Today's Wall Street Journal

Tom Benzoni benzonit at GMAIL.COM
Tue Aug 30 19:23:39 UTC 2016


  FYI only.

tom


www.medscape.com

Survey: EHRs Have Taken Over, Except for Hearts and Minds

Robert Lowes
August 30, 2016

Electronic health record (EHR) systems used to be considered a bandwagon
that physicians would jump on in the hope that digital technology would
improve patient care and maybe even streamline their work.

Medscape EHR Report 2016
<http://www.medscape.com/features/slideshow/public/ehr2016> shows that the
overwhelming majority of physicians are now on the bandwagon, except that
it now resembles a police department's paddy wagon. Most of the people
inside aren't happy to be there.

Ninety-one percent of physicians told Medscape they use some sort of EHR,
up from 74% in 2012. And 56% of these users said the technology has
improved the documentation of patient care.

Beyond that bit of praise, most physicians had little good to say about
their electronic charts. Only around 30% said EHRs improved patient
service, clinical operations, or bill collections. Fifty-seven percent said
the technology reduced the amount of face-to-face time with patients, while
50% said the technology reduced the number of patients they could see.

Medscape put the productivity question to EHR users another way — how does
the software affect your workflow? — and the answers were just as
disheartening.



Some 15,300 physicians across 25 specialties completed the survey online
between June 6 and August 8. Thirty-seven percent were under 46 years of
age, and 58% were men.

*Epic Dominance*

The survey results also demonstrated the continuing dominance of EHR
technology from Epic, a company that caters to hospitals and large health
systems and their cadres of employed physicians. As in Medscape's 2012
survey, Epic's software topped the list of the most widely used EHRs, with
use by 28% of digital doctors compared with 22% four years ago. Among
physicians who work for hospitals and health systems, Epic enjoys an
industry-leading 41% market share.

Even though physicians often don't have any choice in the system they use,
especially if they're employed, Epic users nevertheless gave their software
high marks. It ranked second in an overall rating (3.45 on a 5-point scale)
based on individual scores for ease of use, vendor support, overall
satisfaction, connectivity, and usefulness as a clinical tool.

The Department of Veterans Affairs (VA) Computerized Patient Record System,
the user interface for the VA's VistA system, was rated number 1 at 3.65.
The VA is considering giving up VistA, a home-grown, public domain program
available from the government or distributors, for a commercial EHR.

For physicians in independent practices, the most widely used EHR is
eClinicalWorks at 12%, followed by both Practice Fusion and NextGen at 8%
each. Epic tied Centricity for fifth place in market share of independent
practices at 4% but took first place among independent physicians in the
overall product rating.

*Copying and Pasting Is Common*

EHRs typically give physicians the ability to copy and paste comments from
previous patient visits — think history and physical exam — into the note
for the latest one. This software function, a staple in word processing,
allows physicians to write a note faster, but the Department of Health and
Human Services suspects it's also served as a tool for fraud
<http://www.medscape.com/viewarticle/817604>.

The feds worry that no one edits "cloned" patient information to ensure
that it's accurate and up to date and that many physicians bill for higher
levels of evaluation and management (E/M) services than warranted by
inserting dense blocks of old patient information into a new note.

Copying and pasting is a widespread EHR behavior, according to Medscape's
EHR survey for 2016. Eleven percent of EHR users said they always do it,
while 31% said they do it often. Another 24% are occasional cloners. The
rest do it rarely (18%) or not at all (17%).

The full survey results are available here
<http://www.medscape.com/features/slideshow/public/ehr2016>.

*Follow Robert Lowes on Twitter @LowesRobert
<https://twitter.com/lowesrobert> *


Medscape Medical News © 2016  WebMD, LLC

Send comments and news tips to news at medscape.net.

Cite this article: Survey: EHRs Have Taken Over, Except for Hearts and
Minds. *Medscape*. Aug 30, 2016.

On Tue, May 10, 2016 at 10:42 AM, HM Epstein <hmepstein at gmail.com> wrote:

> Thank you for sharing this. Very interesting. I actually will be receiving
> a data dive into pediatric diagnostic error allegations from CRICO
> strategies tomorrow. I will share the article I write from that with the
> group.
> Best,
> Helene
>
>
> *-- *
> *hmepstein.com <http://hmepstein.com> *
> *@hmepstein*
> *Mobile: 914-522-2116 <914-522-2116>*
>
> *Sent from my iPhone*
>
>
>
> On May 10, 2016, at 9:32 AM, Ruth Ryan <ruthryan at COX.NET
> <ruthryan at cox.net>> wrote:
>
> Laura Landro, a frequent and excellent writer on healthcare for WSJ has
> written an article today based on 40 studies of 10,000 claims from The
> Doctors Company and the specialty-specific lessons learned for safer care,
> with examples given in obstetrics, orthopedics and emergency care. CRICO’s
> data mining for lessons in improvement is also cited.
>
>
>
> http://www.wsj.com/articles/clues-to-better-health-care-
> from-old-malpractice-lawsuits-1462813546
>
>
>
>
>
> *Ruth*
>
>
>
> Ruth Ryan RN, BSN, MSW, CPHRM
>
> Medical writer
>
> Risk management/patient safety
>
> Continuing medical education
>
> Telephone (504) 256-8797
>
> Email ruthryan at cox.net
>
> <image003.jpg>
>
>
>
>
>
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> Moderator:David Meyers, Board Member, Society for Improving Diagnosis in
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Moderator: David Meyers, Board Member, Society to Improve Diagnosis in Medicine


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