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EMR ePrescribing Standard

Did you hear the one about the guy who complained that he was being hung with a new rope?

The government tells physicians that they have to have ePrescribing if their EMR is to meet “meaningful use standards” thus qualifying use for subsidy moolah. Providers can qualify for up to $44,000 in some cases, encouraging them to use ePrescribing. There are those physicians who prefer to dangle from the comfortable old paper rope.

My point about dangling from a paper rope, perhaps dubious, is that maintaining clinical records and writing prescriptions is part of practicing medicine. Is there a better way to write prescriptions than the physician's scrawl on a pad? Yes. Are there problems? Yes again, but nothing that can't be overcome.

The Value of Archiving EMR

Although the law is yet evolving, it appears that the state and federal laws for retaining EMR will likely be the same as for paper charts. But storing paper charts takes up more and more space with the passing of time. You can store EMR virtually forever in the vast chasms of microchips. When you’re dealing with chronic conditions and some other complicated cases, being able to check past charts can be very valuable.

But remember also, if you follow state and local law in disposing of data, then you’re no longer legally liable for something that went wrong but is not documented. But if you are selective in what you delete, that doesn’t look good either. Decisions, decisions.

If you save everything, your database can be huge after a number of years. The larger it is, the longer it takes to back it up. And even a digital database will eventually have size issues. Image files are getting ever larger as they are getting clearer and more detailed.

It’s possible to automatically extract all EMR data previous to a certain date. You can simply delete it or store it somewhere else. If you put it in a data archive, you don’t have to waste time backing it up over and over. You can simply include a link in your EMR software so you can jump to your archive if you have to. Your working data base will remain easy to manage and back up.

Paper Charts After EMR Implementation

So okay. You made the leap. You switched from paper to EMR. Time passed. You’ve got a wall full of paper folders, but you rarely pull one any more. What do you do?

You can hire an HIPAA compliant company to scan them into our computers. That costs. It can even be spendy. But then, tap, tap, you can call up anything you want. The records are indexed. If a patient wants his records, tap, tap again.

Scanning is tedious. You scan them yourself as you go. That will take care of the charts you use the most. Then you can hire somebody to finish them off. Fewer charts for them to scan. Lower cost to you.

Pluses and Minuses of Using Laptops for EMR

Doctors with EMR systems need to access the medical histories of their patients at the point of care. That means they need a computer in the exam room. So what are the advantages and disadvantages of a laptop as opposed to traditional desktop computers?

Is your EMR the Latest?

"The eyes of Doctor T. J. Eckleburg are blue and gigantic—their retinas are one yard high. They look out of no face but, instead, from a pair of enormous yellow spectacles which pass over a nonexistent nose."

These are symbolic eyes, of course, not the real deal. They’re on a billboard mentioned early in F. Scott Fitzgerald’s classic novel The Great Gatsby. By one interpretation, they are the eyes of God.