Wednesday, July 6, 2016

Why Can't I Have a Dentist EHR?



Imagine my surprise and delight when I saw my dentist this week for a check-up and found the electronic health record to be both informative and patient friendly. As I sat in the dental chair, the large monitor screen was swung over in front of me and my dentist was at my side going over it with me. The monitor was not a barrier...it was part of my exam. The print was large, the information on the screen was easy to understand. Together we updated my health history, current meds and corrected errors. She held a small pad and changed things as we spoke. As the exam progressed she was able to swing the monitor over and show me X-rays, a fracture line in my tooth, a hazy spot that needed more investigation. We looked back in time and compared. The computer was a welcome addition in the exam room and the amount of clicking and recording of information was simple and intuitive.


Compare this with the EHR that I use, which by the way, is rated one of the best and is extremely expensive to purchase, install, and maintain.  The user interface is so busy and non-intuitive that to show it to a patient would be distracting and eye-numbing. The number of clicks, scrolling and entries needed to see even one piece of information makes it nearly impossible to use as education for a patient. In fact it is so time consuming and such a burden in the exam room that an entire new industry has sprung up to deal with the EHR called "scribes". It an attempt to free up the beleaguered physician and restore patient-physician eye contact and connection, many doctors are paying for a 3rd person to be there in the room just to record the visit notes and do the electronic paperwork.


My dentist was done charting by the time I left the exam room. I, on the other hand, face hours of after visit typing into my EHR, often long into the night. Even a simple ordering of an e-prescription requires about 6 clicks, entering diagnoses, proper ICD-10 codes,  dealing with alerts that tell me that diagnosis does not qualify to be covered by Medicare, secure sign-ins and special authorizations needed for schedule 2 and 3 drugs, and on and on. That's just one function and one medication. Multiply that my thousands.


No doctor wants to go back to paper charts but we shouldn't accept the current stock of medical electronic health records.


The dental EHR was clealy developed for true dentist workflow and user satisfaction. The medical EHRs were developed for billing, coding and government requirements. I want what the dentists have. And I bet my patients do too.