Electronic Health Records are Awesome — How It’s Being Done is Ludicrous

A short discussion on EHRs and in response to the article by PBS These doctors think electronic health records are hurting their relationships with patients. In 2002 Logen, a company I was the CEO of at the time, set out to create an EHR input system that improved the doctor patient relationship, lowered the time to recording, improved the documentation, increased eye contact, improved CPD coding, improved payment, shortened the cycle from creation to payment, and assisted the doctor in protocol based care. The result of that work was the Logen Medical Management System.
We were very successful with an average transcription time for an initial visit being less than 7 minutes, a follow up visit of 4 minutes, and extensive eye contact throughout the visit. Our system used handwriting recognition on light weight tablets, with suggested protocol based documentation based on symptoms. Patients checked themselves in at the door and all required documentation including prescription, insurance forms, clinical evaluations, radiography, and lab results were embedded into the visit documentation augmented by photographs taken with high definition digital cameras that embedded pertinent photos directly into visit documents at the snap of a button. Quality assurance occurred as the patient left the office with spell checking and CPD code review before insurance submission. Data from the documents was synced with a SQL database for analytics and further reporting.
A great EHR is not an intractable problem. It is a problem based on the major manufactures and thus industry adoption having adopted recording and verification techniques for data acquisition that do not fit the model of delivery, patient interaction. With modern computing there is absolutely no reason that a patient visit and all correlating material cannot be recorded and transcribed with very little interaction with a physical input device by the doctor.
