Becker's Hospital Review

45 HEALTH IT 7. Hayes Wilson, MD. Piedmont Rheumatology Con- sultants (Atlanta). "Our physician assistant quit because she typed with two fingers and it was too lugubrious for her. For me to review one note of hers, it was 38 clicks. If she saw 20 patients, it was 760 clicks a day just to review her notes." 8. Steven Wertheim, MD. Emory Healthcare (Atlanta). "When we first undertook this, we were excited. We started work- ing with the EMR company to say, 'Look, if we're an orthopedic practice, we need to tailor this to us.' Aer about a year and half of that we were making some progress, but as soon as the mean- ingful use issue came out, that was it. Since that day the only thing that our EMR vendor is focusing on is qualifying their systems for the next meaningful use. ere has been no ability for us to customize our system for orthopedics since that day." 9. Steven Wertheim, MD. "It's been a nightmare for us. Be- cause of the way these meaningful use requirements are set out there isn't really a patient portal that is efficient. Our patients hate the patient portal we use and we've used two different patient por- tals. ey just think it's very inefficient." 10. Manoj Shah, MD. Advocate Health Care (Park Ridge, Ill.). "We are not able to meet the stage 2 requirements. We did meet with stage 1, and for three years we did well. is year we just could not do it because they want a portal, they want a connection with an HIE, they want secure messaging and we are not able to do it." 11. James Smith, MD. Emory Specialty Associates (Lawrenceville, Ga.). "I noticed that my patients noticed that as I was trying to talk to them and enter their history and put orders in as I was going — I could tell that they felt I was very detached and more focused on this. So beyond annoying them and my almighty Press Ganey scores going down, I just knew that it wasn't the right thing. I personally had to hire a scribe to do that. at has alleviated a portion of that and allows me to sit at the bedside and be more engaged with a patient, but that's now at a cost of between $25,000 and $30,000 a year out of my pocket." 12. Melissa Rhodes, MD. Respiratory Consultants of (Cartersville) Georgia. "I picked a large EHR program, think- ing they're most likely going to be around for a long time. It was very costly and I'm still paying a huge amount...I now see probably two-thirds the number of patients I saw when I was handwriting my notes. Not only that but when the Internet goes down you're stuck. And the Internet goes down. We have a redundant system that we pay two different Internet providers for, so once again the cost goes up. Does that fix it? No. Not only that but if you get a slight blip in the Internet connection you have to sign back in three different times because of all the privacy rules. It slows you down and the patients just laugh...Not only are you slow, but ev- ery day I go home without finishing my notes, every weekend I'm trying to catch up to make sure my notes are accurate. For several hours every night and at least four on the weekend, I'm trying to play catch up." 13. Andrea Juliao, MD. Dekalb Medical (Decatur, Ga.). "When we first started using EHRs, there was probably six months lag time trying to adopt the system. Patient schedules were cut in half, so that obviously had a burden for patients and us. Now I probably spend a good extra eight to 10 hours per week that I used to not spend just navigating the chart, navigating the documen- tation, electronic prescriptions, patients communication — that used to be a lot quicker before EHR. I just think that giving up 10 hours of my time a week that used to be family time is significant." 14. Marie-Elizabeth Ramas, MD. Mercy Medical Center Mount Shasta (Calif.). "I can tell you that over the last three months, since EHR implementation, my clinical productivity — my ability to take care of patients — has dropped by about a third. People's health is endangered." (As reported by American Associa- tion of Family Physicians News.) 15. Gary Gaddis, MD. St. Luke's Hospital (Kansas City, Mo.). "e EHR our hospital uses does some things well. My pre- scriptions are all legible and it is more rapid to use the EHR than to handwrite them. However, the designers of the soware did not design the system to communicate in the manner that doctors use to communicate efficiently and effectively. e designers of the EHR soware seem to labor under the delusion that to have more data is equivalent to having more useful and actionable informa- tion. For instance, the first data field I see should be the patient's chief complaint, not how they arrived or whether or not they have a primary care doctor. ere are just so many things that seem poorly designed or incomplete in current EHRs." 16. Jerome Seid, MD. St. John Providence (Warren, Mich.). "e idea of EHR is a great concept. Idealistic, but not practical. My eight-member single specialty practice has had EHR for 10 years or so. While it allows for some innovative ways to store and look at data, the process of data entry has made a workday so long that the job cannot end at a reasonable time if a full-time partner is to see the volume of patients needed in a usual clinic day. is has resulted in decreased and lower quality face time due to the need to look at a screen. It has resulted in the inability to fully see, examine, analyze and talk to a patient in the previous 15 minute slot that was given to a routine follow-up visit. at has resulted in a choice I must make between direct care for sick, needy, dying and suffering patients, and the need to satisfy the many EHR requirements to complete the visit." 17. Thomas Young, MD. Greenville (S.C.) Health Sys- tem. "Aer watching my take-home pay drop by 30 percent over the past few years (largely due to the incessant demands of 'mean-

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