As part of our continuing series of TweetChats, Physician’s Weekly, along with co-host Dr. Nicholas DiNubile, hosted the latest #PWChat on May 24 to discuss “EHRs: The Good, the Bad, and the Ugly.”

Dr. DiNubile is an orthopedic surgeon specializing in sports medicine. He is also a clinical assistant professor of the Department of Orthopaedic Surgery at the Hospital of the University of Pennsylvania. Dr. DiNubile has been chosen in “Best Doctors in America” as well as “Guide to America’s Top Surgeons.”

Joined by other physicians and interested patients, we debated topics such as whether or not EHRs are a good investment, potential benefits of EHRs, how to achieve the potential benefits of EHRs, what has kept these benefits from being widely achieved, and much more; so much more that we didn’t get to all the questions, so:

Read the second part of this #PWChat here.

 

 

Below is a recap of the discussion. Follow the full transcript on Twitter.

Question 1

Q1: Why isn’t #EHR adoption higher than the 67% reported in March 2017? #PWChat

— Physician’s Weekly (@physicianswkly) May 25, 2017

A1. Many have been waiting for the right product that fits his work flow and for #interoperability. #PWchat
— Linda Girgis, MD (@DrLindaMD) May 25, 2017

Imagine if Lebron-WHILE PLAYING-had to keep his own stats & document
every move? What would he accomplish? –>docs current #EHR mess #PWChat pic..com/xy3cUI7eBx

— Nicholas DiNubile MD (@drnickUSA) May 25, 2017

Id offer adoption isn’t higher bc we haven’t seen EHRs that meet needs of drs or pts.MU isn’t enough incentive to implement bad tech #PWChat https://t.co/9V7b5o425t
— Erin Gilmer (@GilmerHealthLaw) May 25, 2017

A1 Too many distractons MU/MACRA & unfriendly user interface, IMHO the #EHR should be a visual tool at point of care #pwchat

— James Legan MD (@jimmie_vanagon) May 25, 2017

The folks who have not adopted #EHR have likely decided they should not pay providers for data entry. #PWChat https://t.co/AU8iI4cfuo
— Robert Mahoney (@mahoneyr) May 25, 2017

@physicianswkly Simply put, the incentive isn’t there. Clinicians would rather forgo $ incentive to avoid freedom from workflow shackles. #hitUX#pwchat

— Jake McClure, M.D. (@jake_mcclure) May 25, 2017


 

Question 2

Gonna move on, but feel free to keep discussing Q1
Q2: With so many docs disliking #EHRs, why is adoption at even 67%? #PWChat
— Physician’s Weekly (@physicianswkly) May 25, 2017

@physicianswkly A2: 1/3 Gov’t $$$ incentive (carrot initially→now stick). But never a good “deal” in terms of ROI. More cost than benefit by far. #PWChat

— Nicholas DiNubile MD (@drnickUSA) May 25, 2017

@physicianswkly A2: 2/3 Hospital pressure especially employed docs (no choice) #PWChat
— Nicholas DiNubile MD (@drnickUSA) May 25, 2017

@physicianswkly A2: 3/3 Docs sold a bill of goods by vendors. All hype, never realized. And Gov’t mandates MU MACRA etc #PWChat

— Nicholas DiNubile MD (@drnickUSA) May 25, 2017

A2 I think a lot are employees of large hospital system & use the #EHR of institution + Govt incentives for adoption #pwchat
— James Legan MD (@jimmie_vanagon) May 25, 2017

T2 Adoption is not determined voluntarily. It is a condition of participation in the organization. #PWChat https://t.co/BVJKPfWl5t

— Robert Mahoney (@mahoneyr) May 25, 2017


Question 3

Q3: What has kept potential #EHR benefits from being achieved? #PWChat
— Physician’s Weekly (@physicianswkly) May 25, 2017

Q3 We need to scrap what we have & re-design #EHR putting patient care & docs efficiency FIRST-not Gov’t rules/regs &data collection #PWChat

— Nicholas DiNubile MD (@drnickUSA) May 25, 2017

A3. Government regulation. #MeaningfulUse. #PWchat
— Linda Girgis, MD (@DrLindaMD) May 25, 2017

A3 HC is a business. Top EHR vendors got 2 top, not b/c products work 4 Pt/Drs but b/c vendors work 4 regulators & stockholders #PWChat

— ShereeseM, MS/MBA (@ShereesePubHlth) May 25, 2017

@jimmie_vanagon T3 These are useful but there is hopefully more. Could have hired many data analysts to provide much prettier charts. #PWChat
— Robert Mahoney (@mahoneyr) May 25, 2017

@mahoneyr A3 lots more, med reconciliation, reviewing USTaskForce Recs, Review Past Hx Review reports/xrays & correct any errors etc #pwchat

— James Legan MD (@jimmie_vanagon) May 25, 2017

 

 


Previous Physician’s Weekly #PWChats


Question 4

Q4: What can be done to better achieve potential benefits of #EHRs? #PWChat
— Physician’s Weekly (@physicianswkly) May 25, 2017

Patients SHOULD have portable accurate up-to-date evolving HealthInfo-Not gonna happen w/ current #EHR design & Gov’t mandates #PWChat pic..com/IUz9Dfu0UZ

— Nicholas DiNubile MD (@drnickUSA) May 25, 2017

I think one thing that would honestly help is pts &doctors each seeing the interface of the other. Then working w developers as team #pwchat https://t.co/qmIKhIkB8b
— Erin Gilmer (@GilmerHealthLaw) May 25, 2017

T4 Work on the data entry aspect. More predictive data entry and less redundant clicking. #PWChat https://t.co/s8IOa60AP1

— Robert Mahoney (@mahoneyr) May 25, 2017

@mahoneyr A4 IMHO a #healthCRM in small office enlivens the #EHR & turns into a wickedly efficient beast managed by one good nurse #pwchat with …..
— James Legan MD (@jimmie_vanagon) May 25, 2017


Question 5

Switching gears
Q5: Many docs use copy & paste to avoid huge time suck of #EHR use. Isn’t this dangerous? Can this be done safely? #PWChat

— Physician’s Weekly (@physicianswkly) May 25, 2017

@physicianswkly Extremely dangerous AND dishonest. Also bloats records to almost useless white noise document where critical info lost/hidden #PWChat
— Nicholas DiNubile MD (@drnickUSA) May 25, 2017

Q5. The chart is nio longer a medical record rather a data capturing tool. Hard to see pts and data record at tge same time. #pwchat

— Linda Girgis, MD (@DrLindaMD) May 25, 2017

T5 If you are copy/pasting, you are by definition not adding value in the documentation. #PWChat https://t.co/qVQGDCDd0H
— Robert Mahoney (@mahoneyr) May 25, 2017


Question 6

Q6: Assuming doc is ok w/ using #EHR as far as effort needed/cost/etc, how can focus on screen & not patient be avoided/remedied? #PWChat

— Physician’s Weekly (@physicianswkly) May 25, 2017

I used to use a PalmPilot & stylus for data entry, and patients were fine with it. Switched to phone and they thought I was texting. #PWChat https://t.co/OvGjnIPHbe
— Robert Mahoney (@mahoneyr) May 25, 2017

That said, I think it comes down to form factor. Screen and keyboard is not how we’re going to be doing it in 10 years. #PWChat

— Robert Mahoney (@mahoneyr) May 25, 2017