[dublin]

This attitude is still presenet among doctors, and is one reason why electronic Medical Records still suck, and why Obama's "Affordable Care Act" has made American healthcare simultaneously the most expensive in the world as well as among the worst in the world. Doctors consider their time too valuable to be used in slow and fiddly data entry, so they offload it to additional staff.

They're not entirely wrong in this regard - modern EMR web UIs are arguably inferior in many ways to some light pen driven systems of the 1970s-80s (I'm thinking especially of the old TDS system, which nurses (and the few docs that used them) loved because it was so easy and quick - replacing or "upgrading" it was like pulling teeth, and the nurses fought hard to keep it in every case I ever saw.)

[nradov]

Physician time is valuable. There is essentially a fixed supply and other bottlenecks in the healthcare system make adding more doctors a very slow process. That's why forward-thinking health systems employ medical scribes to offload data entry.

https://www.scribeamerica.com/what-is-a-medical-scribe/

The TDS Health Care System had some unique advantages but unfortunately it was tied to obsolete technology and ultimately a dead end. Web UIs aren't necessarily a problem. Some of the most popular EHRs such as Epic use native thick client applications. The fundamental issue is that healthcare is inherently more complex than almost any other business domain, with every medical specialty needing a different workflow plus beyond the clinical stuff there are extensive documentation requirements imposed by payers and government regulators. Sometimes clinicians and administrators insist on certain functionality even when it makes no sense due to ego or ignorance. EHRs can be improved but I know from painful experience how expensive and time consuming it is to get everything right.

https://dl.acm.org/doi/pdf/10.1145/89482.89511

[ghaff]

The younger docs seem more amenable but there still seems to be a ton of electronic paperwork for the benefit. That said, my "community hospital" got bought by one of the two big systems in my area and, from a patient standpoint, things like prescriptions and labs especially seem much more automated than in the past.

[TheNewsIsHere]

The amount of electronic paperwork seems to be much more than when it was all on paper.

When I was a kid my medical chart was paper. When I was around 13 years old the pediatrician’s office moved to an EMR.

It was more or less a digital version of the same chart.

As I have grown older, and with the benefit of having medical professionals in my family, I’ve seen how EMRs have changed from a distance. From an anecdotal perspective it seems like charting is more time consuming than it used to be. I’ve witnessed many different medical professionals using many different EMR platforms, and poor design seems to be a factor there.

They also deal with more information on a patient and in an aggregate form than paper charts ever did. From what I’ve observed I would venture a guess that more than a little of that is the result of neuroses and anal tendencies on the part of healthcare executives rather than quality improvement initiatives or research oriented objectives. There are other externalities like bad vendor implementation for CMMS requirements, or the continued granulation of conditions into ever more ICD codes, which then need crosswalk databases and interfaces and cross checks.

On the patient side, I’ve only ever truly been impressed by Epic’s portal. Every other one I’ve used is comparative garbage. I have recently been having a conversation with a manager at my doctor’s office trying to understand why and what changed so that chart data that used to be visible to me are now only visible to them, and why they can’t change that. It seems like the vendor implemented a forced change and I may just have to live with having ambiguously incomplete access to data I used to have access to, with no insight into what’s incomplete unless I already know.

With all of that said, at least there’s some access to one’s own health data. And comparing that to my birth records, which are functionally illegible (likely forever), at least what records are kept will be decipherable twenty years from now. Presuming they’re not mangled by a migration, which I’ve seen happen several times.

[vidarh]

US healthcare was already the most expense long before Obama.