I took Mindy the Crippler, PC for her 12-week veterinary appointment today. The doc wrote everything down by hand on paper to be placed in a folder. I asked “Are electronic health records popular among vets?” She responded that vets used computer systems for reminders and recording vaccinations but generally not for the full health record. “It slows everything down too much [to use a computer],” she noted.
The vet world is mostly uninfluenced by insurance companies and government, so I’m wondering if the fact that computerized records apparently don’t yield net benefits in that domain should make us skeptical that they will pay off in human medicine.
[I might add that, unlike in human medicine, Mindy the Crippler, PC was seen on time and I was able to schedule follow-up visits on dates/times that were convenient for me. What did the vet get paid? Seventy-five dollars, which is about 1/6th as much as my doctor charges as a retail rate and almost exactly the same as my doctor gets paid for an exam (see previous posting about my $83 checkup). The vet might be more profitable because the $75 was collected with a simple credit card swipe.]
Orthodontists, I believe, are similarly uninfluenced by insurance companies and government and they provide an interesting contrast to your experience in terms of paper vs. computer.
I was amazed how much the orthodontist has changed since my youth. Back then, the orthodontist, himself, did everything and, of necessity, saw one patient at a time. Nowadays, the orthodontist supervises a roomful (8) of technicians who are skilled in handling the mechanical details (90% of the work in terms or time spent) and, presumably, are paid less than an orthodontist. The orthodontist circulates and consults, as needed.
Everything is done on computers – photo storage, note-taking, making appointments (done right from the computer next to the chair). The orthodontist can email photos to our dentist for a consultation. It is glorious. I don’t know what they use, but the software seems great.
You certainly don’t seem to be impressed by electronic medical records. For me, there’s 3 advantages:
1) When I got married, I joined my wife’s health plan with Kaiser. Then we had kids. At the end of every visit we got a printout of our child’s vital stats plus printed instructions on what we were supposed to do.
It was really helpful to be able to focus on what the doctor was saying instead of trying to write down what they said.
2) Some people prefer to see the same doctor. Some doctors seem very much to prefer seeing “their” patients. Some people don’t care, it’s more important to get an appointment when you want/need it.
I don’t see a doctor very often. I’ve had two of them retire on me. I took in my printouts to see a new doctor but he had access to everything in the past 20 years. Including my info from Providence (local health care system where first doctor retired), then Kaiser
Our vet seems to have gone the electronic records route including automated vaccination reminders, digital photos of our dogs imbedded in their records, etc. I haven’t noticed that it has slowed down service at all.
Mitch: I am not sure that the orthodontist is using a structured medical record system. It may simply be “paperless” in the sense that notes, photos, etc. are kept chronologically in an electronic equivalent of a filing cabinet (much less data entry work).
Jim: I think a lot of what you like is really the “paperless” aspect, which is about 1% of the cost of a structured electronic medical record (keeping basic stats such as height and weight can be done also for minimal $$).
I wrote about this earlier where a cardiologist said that dumping everything in Google Docs and being able to share some documents with other physicians/facilities would provide nearly all of the benefits of a structured system at almost no cost for software and much less time for data entry.
For my entire adult life I’ve foregone dental insurance. As a cash paying customer I always get VIP treatment. Annual cleanings are $80 at my regular dentist. Fortunately, I haven’t needed any costly dental work. On a few occasions, I’ve taken advantage of new patient specials – $60 for full x-rays, cleaning, and exam.