Having to read a note produced by it. Unbelievable. If I have to read one more 10-page note on conjunctivitis. I can't believe how many places they put a medication list.

And, then try getting a transfer from a practice who uses it. You get 200 pages, and you think you are getting a very sick, chronic patient and instead it is a 9 month old with six well visits and two ear infections.

I want to say "reading records from the VA," but never having used or seen Logician, I can't really say that it's worse.

It is, however, similar to what you describe.

Hi Peter,
I've personally used Logician and I've reviewed tons of records produced by the VA system (although never used it).

The VA records are much more readable than Logician. That's saying a lot because the VA records are not easy to read!

Although for once, the federal government made something that is better than what can be found in the private sector.

I nominate Adam for using Logician for three years for the Centricity Award of Honor.

What's aggravating is anyone using Logician in the Bangor area gets an automatic connection to the hospital. They actually have icons on the hospital CPOE and Powerchart system. Last I checked there was no AC icon.

Bert
Adam's red signature is
living proof I don't
abuse my global mod status

Whatever happened to the talk about making the VA software available to private physicians?

I think they did around six or seven years ago. I tried it. It was horrible.

This is funny reading your comments on the VA system. I seem to recall some news editorials and whatnot discussing doctors and the lack of EMRs. And the VA system being held up as a really great one that was made decades ago ( well,2 decades is more than one, right?). Ya'll don't make it sound so great.

It was absolutely horrible. You get what you pay for. Well, except with AC, you get a lot more!

Having to eprescribe with New Crap?

Unfortunately one of the dangers of EMR's is overdocumentation - I remember looking at my medical records when I was a child --

Date - Temp 100.9 c/o sore throat.
Amoxicillin - tylenol.

That was it - now I have a 1 or 2 page chart for many of my little patients with Past Medical, Surgical, Social, Family History, cc, HPI, ROS, med list, full set of vitals and a BMI, physical, diagnosis with problem list and plan with scrips -- still boils down to temp 100.9, sore throat and gave amoxil, tylenol.

Remember just because we do it on computer does not make it better.....remember when computers came out and they had checkbook programs on it, my mom could still balance her checkbook and sometimes faster.

The VA system is superior in terms of its interconnectivity.
My soldier patients tell me that a military or VA doctor in the states can access any test results/office notes from any random military hospital in Iraq or anywhere overseas or around the country.

That aspect is better than any system in the private sector.

HOWEVER, the usability of the system and the readability of the notes has a LOT to be desired.

Exactly, "except with AC." We get a $15,000 EMR for only $1,000. Don't tell Jon he should be charging us an arm and a leg for it.

However I believe if he keeps the price low and aggressively markets it, he could capture a huge market and underprice everyone out there. Wait a minute, he already underprices them all. He just needs people to "discover" AC.

Hi Vicki, New Crap sounds like a wonderful invention. Are you using it in the office? Does it interface well w/ AC?

Obviously I'm joking as were you.

Steven, I did a rotation w/ an old school family doc when I was in school. He was a D.O. that was in practice 35 years.
This is an excerpt from a chart, very similar to yours. However he actually used the SOAP format which I though was cool.

S: fever
O: tonsillar exudate
A: tonsillitis
P: penicillin

There was a D.O. in my town of Brewer, ME who died years ago (Arthur Dearborn, D.O.) but I take care of his family. His son is in his 70's and I care for the son's family/children/grandchildren/great-grand's. It's really quite cool. They toured me through the old family homestead, where Dr. Dearborn practiced. They gave me a few of the antique medical tools. They wanted me to have it all, but I couldn't in good faith accept such a generous gift. Rather I took a few basins and a couple of surgical instruments that we use everyday in our office. He graduated from the original D.O. school in Kirksville, MO in 1932.

I looked a some of Doc's notes. These were truly classic. 3x5 index cards kept in cardboard boxes. He had stacks and stacks of these boxes. On the card read:

Jane Doe
3/2/77
pneumonia
balance $15, paid.

He devoted more letter/characters to the billing than to the office note!

He knows what he did, and his record was just enough to remind him what he did. Which is the purpose of office notes in the first place. He clearly would have prescribed antibiotics in those days, probably a shot of penicillin. He didn't have an insurance company asking for his notes to prove what he did. And he had FAR FEWER lawyers knocking on his door than ours today, touting this line of B.S. "If you didn't write it down, you didn't do it."

If Obama truly wants healthcare reform, we need to go back to the way it was done back in the old days. Keep it simple and keep it real.

and keep it, as you suggested, free of blame. you name an aspect of healthcare, and i say the cost has so elevated as a result of the legal climate.

Those f***ing lawyers are scum.
I've met only one that I respected, and he was a defense atty. He defended me on two cases. He is aweseome.