I decided years ago I wouldn't adopt an EHR. Yes, I use paper charts, with my own hand drawings for the purposes of illustrating TO MYSELF AND THE PATIENT where the suspicious lesions are geographically on their bodies. The lack, of and often nonsensical, governmental communications regarding HIPAA policy on storing, managing and receiving sensitive patient data electronically stopped me. I also practice on an island. Some may think it's paradise. But paradise doesn't come with buried electrical cables, and every tiny windstorm, thunderstorm, or power surge causes our power to go out, and it's always at 10am, in the heat of clinic. I cannot function without electricity, so I close for the day. I can still think, and write by a window for light, just like in the time of Adams. But I can't click away. God bless my colleagues who try. This is why they're quitting and leaving a shrinking pool of doctors or clinics who can accept new patients. The lack of control and endless frustrations with simple infrastructure is driving physicians out of the field entirely.
But I digress.
I searched a bit online, just for fun, about the whole flurry of excitement circa 2008 on EHR. It seems everyone was pushing for EHR implementation, and right quick, with no thought or consideration. Epic is the largest and the most profitable software vendor, contracted to Kaiser Permanente, Mayo Clinic, and lots of other illustrious medical centers. It's got to be good, right? With the imprimatur of world class institutions as clients, and a little old fashioned bribery, it took off.
Here's some interesting reading about the history/origins of Epic--click here.
Here's Michelle Malkin's (love her) pitbull terrier assessment from 2013: click here.
It gets better--she researched that Epic has the lock on EHR for the Dept. of Defense and the Pentagon. The health records of the military. The cake was big, and everyone had a slice at the party: click here.
These weak systems are being hacked for ransom by cybercriminals. A hospital in LA got hacked and held ransom for 17K in Bitcoins--smart financial move with the weak dollar. AND THE HOSPITAL PAID IT AND GOT THEIR RECORDS BACK. We are not privy to the information on where are the hackers, who are the hackers, are they in Ukraine? Panama? Peoria? This info isn't for the plebs. Nothing to see here, keep moving.
Who hasn't gotten a letter that their health information was hacked? I got one from the center where I got X-rays, and my patients regularly get them from other doctors and hospitals and they ask me about it. I tell them that since I don't use EHR's, there is 100% chance that my records won't be hacked. I tell them we're all pawns in the machine. They get unhappy when I say this, like the kid yelling in the playground that there's no Santa Claus. Sorry folks, reality is where I live, wake up and smell it.
Now I see commercials from IBM touting Watson and the supercomputer that beat Jeopardy! It will one day be our collective physician. Look, physicians use it to supercompute through patient data! And the data show the patient had his seatbelt on and the shingles/pneumovax/flu shot!!
Can Watson evaluate the fingernails of a patient with factitial dermatitis, just like Sherlock's sidekick used to do --NO (literary fiction folks, Sherlock Holmes was not real--this is for the Millenials, the group we love to hate). Can Watson smell the alcohol on the breath of the limping white haired man with a total body skin rash for years? No.
Don't tell me it will take my place.
