DrQuit:
Al - sometimes I think you give government too much credit for being organized enough to formulate a P4P idea with the intentions of getting docs to do more for less. Yes, if *** Cheney was behind P4P I think we would have reasons to be suspicious.
Lowell
Lowell,
Not to turn this into a political thread (please, please, please) but it seems to me that it is Hillary and the gang who are looking to have government regulate all our medical care. On the other hand if it was Cheney, I would imagine that penalties for noncompliance might be more "interesting"
?
To address your original question - I believe that there is real value in EMR implementation for surgical specialties. For one thing, in many respects the adoption of an EMR for these guys is easier. For most of them a much reduced subset of templates is required and what they do is more easily templated - e.g. if I am an Orthopod who is a sports med guy, I need knee pain, shoulder pain, and ankle pain templates and I am covered for about 90% of what I do (if I am further specialized I might need just the knee pain template). Standard procedure information - patient prep, patient positioning, medical devices, anesthesia requirements, wound dressing, postop meds, etc. can be defaulted in and put on a template to facilitate surgical scheduling. Routine postop visits can be also defaulted in with the ability to chart exceptions and complications - so if I am seeing a patient during the global billing period ( during which I am not getting paid for each visit) I can literaly complete my follow-up documentation for a patient with no postop complications with 3 or 4 mouse clicks and in about 15 seconds.
Further, where templates get complicated for primary care folks is during the "discovery" period. Specialists usually have a pretty good idea why people are there - Doc, my vision is blurry in my left eye. They don't often get the "I just don't feel right" patient. Plus they are generally treating a specific issue and are not following patients over a long disease course with multiple contributing factors. They generally don't need, nor want to produce the long narrative HPI which can be difficult on a patient by patient basis for the primary care folks.
On the benefit side, recording their data in a structured format obviously allows them to develop good outcome stats, comply with whatever reporting requirements they have or will have and will allow them to adjust their patient treatment modalities based on their own particulart outcomes data and not have to rely on anecdotal stories, case studies from I have a viewpoint vendors or national statistics. If they are practicing good medicine, they will be able to show that. If they need to do better, they will know that. If they are operating on the wrong knee as Mr. Gleemen postulated, I think they have bigger problems than whether they get the right code on their office visits - although the documentation of the visit postop will be a breeze! I suppose they could even do a "wrong knee" template!
Bob Larson
NextGen Healthcare
215-657-7010
Too young for Medicare
Too old for women to care
My posts reflect my own thoughts and are not intended as an official representation of NextGen Healthcare policy or procedure.