Musings of a Dinosaur

A Family Doctor in solo private practice; I may be going the way of the dinosaur, but I'm not dead yet.

Wednesday, September 17, 2008

Welcome to the Paperless Office --NOT--

Some of my charts were reviewed today by a very nice lady working for a company that reviews medical charts for insurance companies. I was told they need to justify medical care received by patients with information from their medical records. One example was that everyone who has ever had their serum protein measured (meaning everyone who's ever gotten liver function tests, which include serum protein, and a comprehensive metabolic profile, which includes liver function tests) need to have their chart reviewed to see if they have documentation of a bedsore. (She tried to explain it; I still didn't get it.)

She came. She sat. She unpacked her laptop computer, set it up and plugged it in. Then she unpacked her spiffy little portable scanner, about the size and shape of a three-hole punch, which she used to scan progress notes from my paper charts into her computer. It was the only way she was allowed to enter the information into her computer, she said.

I mentioned how much easier her job would be in a paperless office. If only I had an electronic medical record, all I'd have to do would be copy the information she wanted onto a CD, or even a thumb drive, if her laptop didn't have a CD drive. Then she could plug it into her machine, click and drag a few things and she'd be all done. After all, wasn't that the promise of the paperless office? (Actually, such an office could just email the information directly to the reviewing company; never mind having to pay for the reviewer's gas and expenses to come all the way out to my office.)

Oh no, she replied. Here is what she is required to do in offices with EMRs:

Each entry in the medical record within the designated time frame must be printed out (on...say it with me, boys and girls...PAPER) for her to feed through her spiffy little portable scanner, one page at a time, to enter the information into her computer.

Guess what happens next? (You just know what's coming...)

All those printouts must then be shredded.

Someone tell me again how much more efficient and environmentally friendly the paperless office is going to make us all?


At Wed Sep 17, 10:12:00 PM, Anonymous Anonymous said...

Please tell me that they looked at my chart, and saw the phrase, "afflicted with terminal pottymouth" written somewhere therein.

Oh, motherfuckin' please.

At Thu Sep 18, 01:23:00 AM, Anonymous Anonymous said...

If they think I am going to let these douchbags come in and waste my time in my fully electronic office, they've got another thing coming.

Print to PDF. Burn on CD. Send to them. Out of sight. Out of mind. They can do whatever the hell they want in their own time.

At Thu Sep 18, 05:36:00 AM, Anonymous Anonymous said...

so where are the dinosaurs?

At Thu Sep 18, 08:49:00 AM, Blogger rlbates said...


At Thu Sep 18, 08:58:00 AM, Blogger jen said...

But the problem there isn't the paperless office, the problem is the idiots who insist that all documents must be scanned in and cannot be entered in any other way.

The company she works for (and/or the company that designed the document management system) just needs to come up with a way to treat the pages of an electronic file as if they were an incoming scan . . . .

Wonder if she or her company provide the shredding service for offices that have gone paperless? (After all, if you're truly paperless, why would you have a decent-sized shredder sitting around?)

At Thu Sep 18, 11:43:00 AM, Blogger Lynn Price said...

I assume there's some logic behind the backasswards print, scan, and shred, but it eludes me. Perchance does her office moonlight at the DMV?

At Thu Sep 18, 08:46:00 PM, Anonymous Anonymous said...

And politicians wonder why we haven't coverted to electronic faster? This is one of many reasons why.

It probably is one of the stupid insurance companies that have a P4P measure giving you a point for having and EMR system in place too.


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