Politico article on the Genesis EMR Rollout

[backrow]

If you haven’t seen this article yet it’s an interesting read. Granted it is likely biased a bit, but so is all the other information that I have heard about how things are going (e.g. It’s been going great, a few hiccups but nothing bad).

“We took a broken system and just broke it completely”

‘We took a broken system and just broke it completely’


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[militaryPHYS]

After I got to the part about blaming the trump administration for a rollout that has been years in the making I tuned out. Obviously biased as you alluded to.

I’m sure the rollout is flawed and poorly planned as most transitions are. Add to that a military system and you get chaos.

 

[pgg]

The article blames in part the military's "ponderous cybersecurity system" ... I totally believe that's the source of most of the function and performance problems the new EMR rollout is experiencing.

I've used a Cerner EMR elsewhere and it worked well. Far superior to Essentris and AHLTA. Eventually they'll get the bugs worked out.


Edit - excess verbosity

 

[narcusprince]

I tried to roll in an automated preop screening program built by a civilian company. But all the IT security protocols and red tape tanked the project. What the military should do is get rid of CAC functionality with EMR systems. Essentially turn all military hospitals and emrs away from CAC enabled to a seperate badging system. And fire all the cyber security folks.

 

[militaryPHYS]

I can just imagine the new online cybersecurity training we are going to have to do (and then redo x5) in the next year or so related to Genesis.

"Read these tips"

 

[Gastrapathy]

“They said they are making changes and physicians will get used to other changes.”

That’s funny.

Every military hospital uses different endoscopy reporting software because none can get through the approval process and they are all frozen in time with their legacy systems.

 

[narcusprince]

“They said they are making changes and physicians will get used to other changes.”

That’s funny.

Every military hospital uses different endoscopy reporting software because none can get through the approval process and they are all frozen in time with their legacy systems.

Gastrapathy
How much of your time scoping patients is slowed down by military systems? I know when I moonlight we can do 12-14 patients by 3pm. It seems in the military it takes all day to scope 7-8 patients. The docs are good but some just do not want to move faster. The big issues I have seen are the endopro they use on the outside the reports take 5 min to enter in the system and most of it is dictated. Versus the military endo client they are typing in their reports which takes longer. With our preop and intraop system i hope they use cerners or client and set the software so that you cannot close a chart unless all peer review metrics have been met. Essentris and innovian allow easy closing of charts that do not meet peer review standards. I was chair of medical records and too much subjectivity was placed in peer review. Seems like with essentris I always get signature deficiencies(im almost convinced someone is opening the charts or editing them this way). Versus in the civilian hospitals In almost 3 years I have had no charts bounce back.

 

[Gastrapathy]

In my civilian practice, I do 8-10 per half day. It was more like 5-6 in the .mil. Lots of factors (slow govie nurses, recovery space limits, and a total lack of incentives to do more for anyone including the MD).

 

[DrMetal]

My favorite EMR remains to be Microsoft Office and notepad. Build your own templates, copy and paste your way to happiness.

 

[Cooperd0g]

Edit - excess verbosity

Dude, that article was excess verbosity. Talk about tl/dr.

 

[ArmyTiger]

My favorite EMR remains to be Microsoft Office and notepad. Build your own templates, copy and paste your way to happiness.

Asutype may be the only program the government hasn't messed up. So many templates, so much time saved.

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[DrMetal]

Asutype may be the only program the government

It's installed on your computers at work?

 

[ArmyTiger]

It's installed on your computers at work?

It was by default at my last duty station, but I had to request it at my current one. Wasn't too hard to get, though. The PACS client was harder to get installed.

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[Chonal Atresia]

In my civilian practice, I do 8-10 per half day. It was more like 5-6 in the .mil. Lots of factors (slow govie nurses, recovery space limits, and a total lack of incentives to do more for anyone including the MD).

You can extrapolate this comment to all government-run healthcare.

I’ll do 8-10 smaller cases at our surgery center by 12 PM and then go see 20 patients in afternoon clinic. This schedule would require 2 full days in military medicine.

Bottom line is you can’t change human nature. There is a financial incentive to “move the meat” in civilian private practice that just doesn’t exist with 8-4 “employed” salary positions with the government (whether DoD or VA).

This fact WILL NEVER CHANGE. When my OR ended early while I was on active duty, I left and hung out with my kids, played golf, etc. Now in private practice, I book a clinic.

The main way the DoD/VA fills any GS/contract positions at all is through retired military that are told old to start in private practice or those docs that can’t get hired anywhere else. Sure, exceptions exist but anecdotally this was my experience.

Why would you work for way less?

 

[pgg]

Welcome back @Chonal Atresia, long time no see.