Wheat vs Chaff

[Guest guest]

Responding to Gordon's charge that 90% of the current EMR's are aimed

at " line item " documentation for E & M reimbursement.

My first motivation years ago in becoming involved with EMR's was to

use a " better mousetrap " -- i.e., make it easier (and especially

faster) do to better medical documentation. I tend to be pretty

detail oriented in my notes (and a bit slow, too). I probably was

affected by the " better documentation is the best legal defense "

mantra. Somewhere in there a new mantra started that ran " good paper

is good quality " . Yikes! We can now generate a volume of paper in

spades with computers, so I think it's shifted a bit even more

to " just documenting everything you did is good quality " .

Whatever you think about this linking of quality to the quanity of

documentation, it's a necessity for payment these days. The quantity

of " new age " medical notes is tedious, however, and makes me

personally nuts. I still like a well thought out succinct medical

note. That seems more like real quality to me.

and I were having this discussion awhile back via email with

another doc, and devised a simple " Wheat vs Chaff " view of the

medical record, where you could tag all the stuff that is " Chaff " ,

and make it drop out by clicking a button -- so now you see

the " consult view " , not the " copiously repetitive " view. We haven't

really pushed the idea in Tkfp too much, though.

I like this idea. Print all the stuff the insurance company wants --

it seems to be a necessity if you want to get paid. Click a button

to drop out the filler when you view the note yourself, or send it to

a collegue. Tagging notes in this way is not really hard from a

programming viewpoint. It would require a little extra attention to

makes sure the note is tagged the way you want while generating it,

however.

Jerry

[Guest guest]

Ummm... you need to change your system of remuneration!

>

> I like this idea. Print all the stuff the insurance company wants --

> it seems to be a necessity if you want to get paid. Click a button

> to drop out the filler when you view the note yourself, or send it to

> a collegue. Tagging notes in this way is not really hard from a

> programming viewpoint. It would require a little extra attention to

> makes sure the note is tagged the way you want while generating it,

> however.

>

> Jerry

>

--

Graham Chiu

http://www.synapsedirect.com

Synapse-EMR - innovative electronic medical records system

[Guest guest]

I have thought this was what was needed for a long

time. What I do is simply put the stuff I care about in bold

before I save the note.

dts

From:

[mailto: ] On Behalf Of Jerry Park,

D.O.

Sent: Sunday, January 06, 2008 7:35 PM

To:

Subject: Wheat vs Chaff

Responding to Gordon's charge that 90% of the

current EMR's are aimed

at " line item " documentation for E & M reimbursement.

My first motivation years ago in becoming involved with EMR's was to

use a " better mousetrap " -- i.e., make it easier (and especially

faster) do to better medical documentation. I tend to be pretty

detail oriented in my notes (and a bit slow, too). I probably was

affected by the " better documentation is the best legal defense "

mantra. Somewhere in there a new mantra started that ran " good paper

is good quality " . Yikes! We can now generate a volume of paper in

spades with computers, so I think it's shifted a bit even more

to " just documenting everything you did is good quality " .

Whatever you think about this linking of quality to the quanity of

documentation, it's a necessity for payment these days. The quantity

of " new age " medical notes is tedious, however, and makes me

personally nuts. I still like a well thought out succinct medical

note. That seems more like real quality to me.

and I were having this discussion awhile back via email with

another doc, and devised a simple " Wheat vs Chaff " view of the

medical record, where you could tag all the stuff that is " Chaff " ,

and make it drop out by clicking a button -- so now you see

the " consult view " , not the " copiously repetitive " view. We

haven't

really pushed the idea in Tkfp too much, though.

I like this idea. Print all the stuff the insurance company wants --

it seems to be a necessity if you want to get paid. Click a button

to drop out the filler when you view the note yourself, or send it to

a collegue. Tagging notes in this way is not really hard from a

programming viewpoint. It would require a little extra attention to

makes sure the note is tagged the way you want while generating it,

however.

Jerry

[Guest guest]

You can't look at the cost of an EMR in isolation. If you add an EMR, but fail

to change the way you work the cost of the EMR IS simply additive. IHowever, if

you change the way you work; replace employees, have increased efficiancy then

the cost ( which is also depreciable) can be a true savings. The " big box " EMR's

may look expensive, but are not if used correctly. I figure my EMR saves me

$30-60k a year and is 100 times more efficient than paper charts, so it seems a

no brainer, and a bargain at $1800/year.

________________________________

From: on behalf of Jerry Park, D.O.

Sent: Sun 1/6/2008 8:34 PM

To:

Subject: Wheat vs Chaff

Responding to Gordon's charge that 90% of the current EMR's are aimed

at " line item " documentation for E & M reimbursement.

My first motivation years ago in becoming involved with EMR's was to

use a " better mousetrap " -- i.e., make it easier (and especially

faster) do to better medical documentation. I tend to be pretty

detail oriented in my notes (and a bit slow, too). I probably was

affected by the " better documentation is the best legal defense "

mantra. Somewhere in there a new mantra started that ran " good paper

is good quality " . Yikes! We can now generate a volume of paper in

spades with computers, so I think it's shifted a bit even more

to " just documenting everything you did is good quality " .

Whatever you think about this linking of quality to the quanity of

documentation, it's a necessity for payment these days. The quantity

of " new age " medical notes is tedious, however, and makes me

personally nuts. I still like a well thought out succinct medical

note. That seems more like real quality to me.

and I were having this discussion awhile back via email with

another doc, and devised a simple " Wheat vs Chaff " view of the

medical record, where you could tag all the stuff that is " Chaff " ,

and make it drop out by clicking a button -- so now you see

the " consult view " , not the " copiously repetitive " view. We haven't

really pushed the idea in Tkfp too much, though.

I like this idea. Print all the stuff the insurance company wants --

it seems to be a necessity if you want to get paid. Click a button

to drop out the filler when you view the note yourself, or send it to

a collegue. Tagging notes in this way is not really hard from a

programming viewpoint. It would require a little extra attention to

makes sure the note is tagged the way you want while generating it,

however.

Jerry