Doctors are not Clerks

Sometimes in IT, you see glaring problems that seem so simple.  And then you look a little closer.  That's where I was when a nurse friend of mine was telling me about how the doctor she worked for had broken 3 keyboards, gave up his vow not to cuss, and was missing his beloved Kentucky basketball games.  The reason why?  "10 years of school, 14 years of practice, and now I'm a clerk".
Electronic Medical Records - Gotta get there
Don't get me wrong. I am a very pro-EMR guy. I am an evangelist for electronic medical records and networking information together, personal health records and all the rest. The cost savings are real, and the impact of connecting all of these "islands of information" on patient care can make a real difference.
I've read some articles lately where isolated issues of mistakes and security have been problematic. Two things will always be true in computers, Garbage in - Garbage Out. And the computer only does what it's told to do. In other words, the issue isn't the digital record, it's the implementation that messed thing up.
With that background, I guess I look at EMRs the same way. If you look at the statistics about EMR adoption, EMR that have been disposed of, and EMR impact on physician productivity - the numbers are staggering. And embarrassingly poor.
But why are the results so bad?
I'm not going to get into all of the issues, but one that just seems so straightforward to me. Yes there are exceptions, but for the most part, EMR vendors have justified their price by selling the elimination of transcription costs. Then they rip the tape recorder out of their hands and give them a keyboard. Sure, there are pull downs and decision trees, with point and click, and tablets. But for the most part, the EMR has taken mobility away, and turned the most expensive person in a practice and turned them into a clerk. By the way, that very expensive clerk is also probably the least efficient computer user in the office.
So let's trash all the EMRs and stick with paper, right? Of course not.
Voice Recognition -Part of the Solution:
Yes, VR has had some fits and starts too.  And when I use my voice dial on my cell phone and say "Call Mike Davis", it comes back with "Calling Pizza Hut".  Grrrr
But like anything, the allure of a gazillion consumers drive VR companies to solve that market.  One that shows up int healthcare is Dragon. A great software package which does a terific job of turning voice into text, right there on your screen.  But here we go again - the doctor is now editing his/her own jobs.  Again the doctor is a clerk.  Further, there are lots of support issues anytime you load consumer grade, machine-based software, into an enterprise environment.
More importantly, how does the document really fit into the workflow of clinical documentation?  How is it returned?  Networked?  Shared?
Do EMRs have Voice Recognition?  Sometimes.  But usually they suffer from being poorly implemented and it's obvious that they're bolted on, and not really part of the normal, natural design of the product.
So, what's the answer?  Embrace Integrated Dictation

Ultimately, EMRs/EHRs and the rest will solve this issue with some emerging technologies that allow for voice recognition with "chunking", and tagging data. But there are answers today.  One of my clients, VocalEZ, clearly understands the issues, because their founder grew up in this very specific space, and set out to design the solution with the individual practitioner at the base.  By integrating into whatever systems (PM, EMR, paper) are in place, VocalEZ can leverage all of the scheduling, referring, and demographic information in the systems, and slide right into the existing doctor work-flow. And by utilizing a Speechmike, which looks and acts suspiciously like a digital recorder, or a mobile device, the doctor can dictate just like always.  While they go see the next patient, the job is processed by some very robust VR software (up to 99% accurate). and ready for a staff member or contracted resource to edit, and it's automatically returned to the designated task basket, file server..Net result - Doctor is a Doctor, and the transcriptionists become editors that can be more than twice as productive, thus cutting costs and time dramatically. So, if you don't have an EMR, and are holding off because of all the reform uncertainty, this is your bridge.  If you have an EMR, but are struggling with adoption, this is your driver.
When I learned about VocalEZ, I felt like the guy at Chrysler who said "why don't we put a sliding door on the driver's side of the vans too?"