All doctors know EMR is a pain and a leading cause of physician burnout ... 

.. but few of us grasp the the depth of the depravity in the Electronic Health Industry until now.

New investigative reporting is shining the light of day on a backwater of fraud, cheating and lies that surrounded the roll out of EMR starting in 2009.

Starting that year, $38 Billion dollars in subsidies for installation of EMR software and attestation to its "meaningful use" have been allocated by the federal government. The response of the EMR industry to that size pile of money was equivalent to giving a school of great white sharks the carcass of a dead blue whale. A similar feeding frenzy ensued. 

A significant portion of the EMR industry's response to these stimulus funds appears to have been illegal, harmful or both.  

New reporting by Fortune Magazine and Kaiser Health News is collating all the settlements and whistleblower cases into one article so we can all witness the Soprano-style attack on this facet of our healthcare industry.

Turns out some players in the industry constructed a maze of fraud, lies and kickbacks - to the tune of billions of dollars so far. (Tony would have been so proud)

That's right, multi-million dollar systemic and protracted cheating and lying in the EMR industry - already caught, prosecuted and settled for over a billion dollars in fines and claw backs to date

Stop Physician Burnout - 4th grade math shows the epic fail of the current practice of medicine

We don't need no stinking spreadsheets

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Let me show you a simple, reproducible, fourth grade math demonstration of the power of team based care and up-staffing the back office. Along the way you will begin to sense the staggering waste in the current practice of medicine, caused in part by industry standards like the MGMA annual staffing survey.

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The reason EMR is killing doctors is simple -- OVERWHELM

Doctors were never meant to handle both
1) the complex interactions and thought processes of diagnose and treat, teach and manage patients
2) AND the digital documentation of those interactions via any one of the current truly demonic user interfaces.

The implementation of EMR doubled the workload on the doctors.

Most employers did not staff up to handle it. Instead, relying on annual staffing surveys to show them the average back office staffing ratio is the same as it was back in paper chart days - 1 Doc + 1 Medical Assistant. 

That's right, the work load doubled without a change in the number of hands on deck.  The documentation falls on the doctor simply because:

- we are ultimately liable for what is in the chart
- we don't punch the clock and stop working at 5PM

It is as if someone designed the system of care specifically to burn out doctors and now they use industry averages to reinforce the travesty. You can't design a more perfect meat grinder for the average doctor and now it is considered the standard of care.

The result:

• Two hours in the chart for each one hour of face time with patients - "Pajama time"
• Burnout rate in US physicians hovering at 50%
• It's a healthcare delivery failure of epic proportions

A 4th Grade review of the numbers reveals a way forward

EMR Power Training

Two ways to consistently lower you TITO week to week

TITO = Time In The Office

How can you build an office day where you spend more face time with your patients than keyboard time with your EMR?

Too often I speak with physicians who are spending hours after the last patient on EMR documentation and - tragically - even more hours grinding away at the keyboard from home after they tuck the kids into bed. If that feels familiar to you, I promise it does not have to be that way.

Here are two ways to start permanently lowering your own personal TITO week after week by cutting down the amount of time you spend typing into your EMR. These are two pieces of a comprehensive strategy to address the dilemma of EMR.