RedlineDoc's blog

I'm amazed. Its been since November since I wrote here and yet nothing has really changed.

The blog which I've been making has skipped a bit. The system is now in 3 weeks. Current problems include not being able to see a past diagnosis without getting the exact date of care, not being able to see past diagnoses when making a bill (superbill), and persistent log-outs (all the way out) when locking the screens for HIPPA purposes.

The first and second, not being able to see or call up past diagnoses would normally be only a partial nuisance; however, the system expects a diagnosis and treatment for each visit and that information may be available in the paper chart. Ah yes, the paper charts. We are doing a parallel system awaiting the install of the EMR side of the system. As before charts are hard to locate and more difficult to find than ever. Although the notes are still written , the diagnoses are not carried forward so unless the clinician wrote the (coded) diagnoses and treatments, its anyones guess.

I realize that today is in the US a day for voting and for possible change for the US healthcare swamp. It may have been a system at one time but has disintegrated into a rabble of territoriality, infighting and control. We need change in the system.

I had a unique opportunity this week to speak to people from five national regions and get some insight into the healthcare system or non-system in their countries. For the most part these were small to medium employers in the UK, Canada, Thailand, France and Germany. In general the European system is, from the employers viewpoint, in chaos but works to provide multilevel health care at a cost. There is always an opportunity for upper middle and upper class folk in Europe to chose their healthcare and pay for it. There are some insurers, but few.

I thought about this as I was in the midst of a system implemented by a CCHIT certified group. My thought was kakistocracy.

I have the pleasure of being in the midst of a medium size install from paper record to computerized system. There are 25 providers and 80+ ancillary, administrative and financial staff. Training was an issue immediately. The company had fixed training courses available to the group from 1030-1130 or 1 pm -2pm for a five day run. Our organization had made no preparations to close for the changeover.

Our first glimpse of the system was provided by our IT manager who clicked through a group of features from the system. When something wouldn’t work, he’d say “we’ll get to that later’. He is an able and competent administrator but clearly overwhelmed by what happened next. We, the staff, had one other opportunity to see the program in training mode one week before the changeover date. It was done on a projected screen, not on distributed computer. We had no hands on experience.