Competency In [compurized records] Technology
MangroveRoot
"An Act to Promote Cost Containment, Transparency and
Efficiency in the Delivery of Quality Health Care"
includes the following provision:
"Physicians would have to show competency in the technology
for medical board registration."
I am not a health-care provider,
but I do receive a small variety of services from various doctors
of various specialties.
I am computer software engineer of over 30 years experience,
and am known by friends and acquaintances for extolling the virtues
of computerization of nearly everything.
And, to a certain extent, I understand and applaud the state's
inclination to get the computerization of medical records
accomplished in some rational fashion.
What I specifically object to, however, is the provision given above.
I have had some doctors who were perfectly comfortable taking
notes on the computer during an visit.
Others have found it distracting and interfered with their medical
objectives, which are, after all, the point.
Even worse, some have sustained injury -- perhaps permanent -- due to
RSS because of a requirement by their clinic to enter everything on the
keyboard, personally, during the course of the visit.
It could be -- and undoubtedly will be -- argued that doctors who have,
or who develop, damage due to RSS can simply turn to voice-input
technology. I'm not at all convinced that that will be an effective
means of transcription in the time frame this bill envisions.
Furthermore, I think it's clear that having the doctor interrupt the
conversation or examination to dictate notes to a computer,
and then make sure that they were recorded properly,
would be disruptive.
I could go on picking nits, but my overall point is this:
Despite being a computer engineer and "booster" of computerization,
I think that requiring physicians to utilize this technology,
or even to *know how to* utilize it in order to be certified is a very
bad idea.
By way of alternative, I might propose the following:
It would be required that a physicians records
be kept in a computerized form.
The format of those records should conform to some standard,
although they should be allowed to contain extra information,
if the physician or employing organization deems it necessary,
appropirate, or desirable.
It should be acceptable for the physician to record their notes
by whatever means -- handwritten, oral, or directly entered --
they find most convenient, appropriate, comfortable, and safe,
*with the proviso* that after they have been entered into the
computerized form, the physician review the computerized transcript
and compare it with their own notes, and confirm that the one
is an accurate representation of the other.