Electronic records are driving doctor burnout | Opinion

Doctors are being driven daffy by electronic health records, or EHRs.

Electronic records are driving doctor burnout | OpinionThat’s the takeaway from a recent report in the Journal of the American Medical Informatics Association. Seven in 10 Rhode Island doctors surveyed who used electronic health records said that the technology stressed them out. Those who reported health information technology-related stress were anywhere from 1.9 to 2.8 times as likely to burn out. In Pennsylvania, 45 percent of physicians report feeling burned out, according to a separate survey from Medscape.
They can thank the federal government for these professional headaches. A decade ago, the Obama administration pushed doctors to adopt electronic records in hopes they’d speed up the provision of care and improve health outcomes. Ten years on, these mandates have delivered much the opposite.

The federal mandate that doctors adopt electronic health records was included as part of the American Recovery and Investment Act — more colloquially known as the 2009 stimulus package.

President Obama boasted that the program would “cut waste, eliminate red tape, and reduce the need to repeat expensive medical tests.” The idea was that a mass upgrade of the nation’s health IT would facilitate the sharing of information among physicians and hospitals — and ultimately lead to more accurate diagnoses and more effective and efficient treatment.

The information technology revolution had transformed so many other parts of the American economy. Why couldn’t it do the same for health care?

The government’s carrots and sticks worked. From 2009 to 2015, the share of hospitals using a basic electronic health records system increased from 12 percent to 84 percent.

The programs on the market are often clunky, time-consuming, and insensitive to the complexities of modern medicine. Physicians, who already face suffocating administrative burdens, are logging ever-increasing amounts of data that have little clinical relevance. Time with patients is disrupted by an endless flood of alerts and messages.

Two-thirds of doctors say electronic records degrade their patient interactions, according to a survey from the Physicians Foundation. More than half of physicians report that the records reduce efficiency; more than a third say they diminish the quality of care.

Screen time has replaced face time. Only one-fourth of the average doctor’s day is spent face-to-face with patients. Half is devoted to electronic health records and other administrative tasks, according to a study published in the Annals of Internal Medicine.

The shortage could grow even worse if doctors react to the burdens federal pressures have foisted upon them by leaving the profession. The Physicians Foundation found that roughly eight in 10 doctors had reported feelings of burnout. Nearly half of doctors are looking to change career paths.

Rolling back the federal electronic health records mandate won’t stop doctors and hospitals from incorporating health information technology into their practices and facilities. Instead, it will allow them — not the government — to decide how to balance patient care and technology use. In theory, clinicians will use technology to improve their ability to deliver high-quality patient care — rather than using technology simply to satisfy the government.

Doctors choose their profession because they want to heal people, not fill out paperwork. It’s time for the government to get out of the way and let physicians actually practice medicine.

Sally C. Pipes is president, CEO, and Thomas W. Smith Fellow in Health Care Policy at the Pacific Research Institute. Her latest book is “The False Promise of Single-Payer Health Care” (Encounter 2018). @sallypipes.

Posted: January 16, 2019 – 12:13 PM

New Study Reveals EHR-Related Malpractice Suits On The Rise

More than 90% of hospitals and 80% of physicians’ offices now have electronic health records (EHRs) – and while the digitization of medicine has improved patient safety, it also has a dark side. Today The Doctors Company, the nation’s largest physician owned medical malpractice insurer, published a new study showing that EHR-related malpractice suits are on the rise.

The study reveals that claims in which EHRs are a factor grew from just 2 from 2007 through 2010 to 161 from 2011 through December 2016. Typically, the EHR is a contributing factor in a claim, rather than the primary cause, according to David B. Troxel, MD, study author and medical director at The Doctors Company.

It’s the second study of its kind by The Doctors Company, which recognized early on that despite the potential of EHRs to advance the practice of good medicine and patient safety, there would be unanticipated consequences from this rapidly adopted new technology. The latest research compares 66 claims made from July 2014 through December 2016with the results of the first study of 97 claims from 2007 through June 2014.


Medical Document Services of Kansas, LLC (MDS) is a Wichita, Kansas healthcare document service specializing in Medical Billing, Medical Transcription, Scribe Services, and AzaleaHealth EHR.   We provide efficient, accurate, affordable quality services for hospitals, clinics, and facilities of all sizes.   Call 866-777-7264 today, or visit our website for more information.  We have education programs in Medical Scribe Specialists. #MedicalTranscription #AzaleaHealthEHR #RevenueCycleManagement #MDSofKansas #MedicalBillingService #MedicalScribes

What do patients and healthcare professionals think of EHRs?

A new survey from SelectHub, a technology selection management company, examined the thoughts of medical professionals and patients regarding electronic health records.

What do patients and healthcare professionals think of EHRs?

The team interviewed 1,007 Americans who have access to EHRs, as well as 107 healthcare professionals, including nurses, physician assistants, administrators, technicians and medical laboratory scientists. In an email, Chris Lewis, a creative partner of SelectHub, said the survey results were not limited to users of a certain EHR vendor or system.

Apparently, healthcare workers and patients both have a fairly positive sentiment of EHRs — at least according to the survey.

These results are surprising, given that electronic health records are often considered something healthcare workers love to hate.

Despite these favorable viewpoints, EHRs don’t seem to be cutting down on the amount of time professionals spend on health records. Among those who switched to using an EHR system, the average number of hours per week spent on health record work only decreased from 19.7 hours to 18.6 hours.

Additionally, 81 percent of professionals said EHRs have increased general workplace productivity.

The SelectHub survey included a wide range of healthcare participants, such as administrators, medical laboratory scientists and office receptionists. But it is interesting to note that a study out of the University of Wisconsin and the American Medical Association found that at least among primary care physicians, EHRs are time-consuming and only complicate matters. According to that study, EHR-related tasks take up nearly half of the average PCP’s workday.

Among patients included in the SelectHub survey, 60.4 percent expressed a generally positive opinion of EHRs, and 19.7 percent had a very positive opinion. Additionally, 16.6 percent had a neutral stance, 3 percent had a negative opinion and 0.3 percent indicated a very negative opinion.

“Perhaps the most surprising aspect of our research though was the reasoning behind patients’ support of EHR technologies,” Lewis said via email.

Seventy-six percent of patients said they believe their doctor’s use of an EHR has either a positive or very positive impact on the healthcare they receive.

“Furthermore, those who received thorough instructions on EHR use and access reported accessing their records more than twice as frequently, suggesting a potential need for more information resources for patients,” Lewis added.

Photo: Mutlu Kurtbas, Getty Images

Medical Document Services of Kansas, LLC (MDS) is a Wichita, Kansas healthcare document service specializing in Medical Billing, Medical Transcription, Scribe Services, and AzaleaHealth EHR.   We provide efficient, accurate, affordable quality services for hospitals, clinics, and facilities of all sizes.   Call 866-777-7264 today, or visit our website for more information.  We have education programs in Medical Scribe Specialists. #MedicalTranscription #AzaleaHealthEHR #RevenueCycleManagement #MDSofKansas #MedicalBillingService #MedicalScribes

National MT Week: May 14-20

As we get ready for National MT week, let’s take a look at the importance [still] of the Medical Transcriptionist in today’s healthcare industry:

    • A skilled workforce produces quality documentation. Healthcare documentation specialists (HDSs) and medical transcriptionists (MTs) ease the documentation burden from physicians.
    • HDSs and MTs consistently achieve documentation accuracy rates higher than 99%,¹ and by harnessing this workforce’s expertise, clinicians’ time, coding, and revenue are optimized and the data governance strategy is strengthened.
    • The narrative allows physicians the opportunity to add the qualitative information that provides context to the patient’s medical history and care. HDSs and MTs understand the complex story-telling of patient care and are experts in document standards and data capture.
    • Your healthcare documentation team are highly skilled, analytical quality assurance specialists who provide risk management support in capturing healthcare encounters and making sure they are documented in a way that promotes clinical clarity and coordinated care.
    • HDSs and MTs need to be positioned to ensure accurate documentation of care encounters and to identify gaps, errors, and inconsistencies in the record that may compromise care or compliance goals.
    • HDSs’ and MTs’ body of knowledge is vast and includes pharmacology, human disease processes, anatomy and physiology, HIPAA, privacy and security, and diverse technologies used to capture health data.
    • Certify to healthcare delivery that HDSs and MTs have the training and expertise to be valued among the allied health and HIM delivery teams by earning and maintaining your professional certification.

#NMTW     #PrecisionMatters

Medical Document Services of Kansas, LLC (MDS) is a Wichita, Kansas healthcare document service specializing in Medical Billing, Medical Transcription, Scribe Services, and AzaleaHealth EHR.   We provide efficient, accurate, affordable quality services for hospitals, clinics, and facilities of all sizes.   Call 866-777-7264 today, or visit our website for more information.  We have education programs in Medical Scribe Specialists. #MedicalTranscription #AzaleaHealthEHR #RevenueCycleManagement #MDSofKansas #MedicalBillingService #MedicalScribes


Vitamin K2: Heart and Bone Health

By Dr. Mercola

Most everyone, including many conventional physicians, have begun to appreciate the importance and value of vitamin D. Few, however, recognize the importance of vitamin K2, which is nearly as important as vitamin D.

Dr. Dennis Goodman,1 who was born in South Africa and trained at the University of Cape Town, has multiple board certifications in cardiology (and several subspecialties) and holistic integrative medicine.

After his internship at the Grootte Schuur Hospital—where Dr. Christian Barnard did the first heart transplant in 1967—he came to the US, where he did his cardiology fellowship at the at the Baylor College of Medicine in Houston, where Dr. Michael DeBakey performed the first bypass surgery.

“I was really very lucky to be in a situation where I had these two cardiac giants as mentors and teachers,” he says.

Dr. Goodman is also the chairman of the Department of Integrative Medicine at the New York University (NYU), and has authored the book, Vitamin K2: The Missing Nutrient for Heart and Bone Health. In it, he explains why vitamin K2 isevery bit as important as vitamin D.

“For 20 years I was putting stents in; running around day and night at the hospital. When I got called to the emergency room for someone having a heart attack, I was like a fireman putting out a fire in a house.

Sometimes, you were very lucky and could save the house from burning down, and sometimes not.

What I started to realize is that prevention is really the key for us to making the maximum impact. I’ve always been interested in the idea that everything we need to be healthy is provided by the Lord above –namely what’s out there for us to eat.

80 percent of these chronic diseases including atherosclerosis, heart attacks and strokes, diabetes, and obesity are preventable. So I got into the whole idea of learning integrative medicine,” he says.

He was the chief of cardiology at Scripps Memorial, and went on to Scripps Clinic for Integrative Medicine for many years.

“Obviously, when you understand holistic medicine, you understand that so much of what we’re doing, unfortunately, in traditional medicine is procedures, testing, and prescribing drugs, because that’s what we’re taught—and making diagnoses instead of taking care of people who basically may not have a disease, but are not healthy and well.”

As a cardiologist, it’s quite appropriate to delve into vitamin K2, as it has two crucial functions: one is in cardiovascular health and the other is in bone restoration.

It performs many other functions as well, but by helping remove calcium from the lining of the blood vessels, vitamin K2 helps prevent occlusions from atherosclerosis.

Vitamin K Basics

Vitamins K1 and K2 are part of a family, but they are very different in their activity and function. Vitamin K1, found in green leafy vegetables, is a fat-soluble vitamin involved in the production of coagulation factors, which are critical for stopping bleeding.

This is why when someone’s on a blood thinner such as warfarin, they need to be careful not to take too much vitamin K1, as it will antagonize the effect of drug. Vitamin K2 is very different. There’s a complex biochemistry that occurs with K2 involving two enzymes:

  • Matrix Gla-protein (MGP)
  • Osteocalcin

“Gla” is short for glutamic acid. Glutamic acid is imported into the cells in the wall of your arteries, where it binds to calcium and removes it from the lining of your blood vessels.

Once removed from your blood vessel lining, vitamin K2 then facilitates the intergration of that calcium into your bone matrix by handing it over to osteocalcin,. The osteocalcin then helps cement the calcium in place.

Vitamin K2 activates these two proteins. Without it, this transfer process of calcium from your arteries to your bone cannot occur, which raises your risk of arterial calcification.

“Vitamin K2 is like a light switch—it switches on MGP and osteocalcin, which takes calcium out of the arterial wall and keeps it in the bone.

There’s so much information showing this relationship between osteoporosis (not having enough calcium in your bones) and having an increased incidence of heart disease. What’s actually happening, I think, a lot of patients are vitamin K2-deficient,” Dr. Goodman says.

“So now, I tell all patients – especially when they have risk factors for calcification – ‘You’ve got to get vitamin K2 when you take your vitamin D, and your calcium, and magnesium.’ Because we need to make sure that the calcium is going where it’s supposed to go.”

Statins May Increase Arterial Calcification by Depleting Vitamin K2

Besides a vitamin K2-poor diet, certain drugs may affect your vitamin K2 status. Dr. Goodman cites a recent article2 in the Journal of the American College of Cardiology, which suggests statin drugs may increase calcification in the arteries.

Interestingly enough, another recent study3 published in the Expert Review of Clinical Pharmacology shows that statins deplete vitamin K2.

“For me, that is so huge because if that’s true, everybody that is put on a statin, you want to make sure they’re also taking vitamin K2,” Dr. Goodman says.

This is an important observation, considering one in four adults in the US over the age of 40 is on a statin drug. Not only do all of these people need to take a ubiquinol or coenzyme Q10, which is also depleted by the drug, it’s quite likely they also need vitamin K2 to avoid cardiovascular harm.

Sources of Vitamin K2

Vitamin K2 is produced by certain bacteria, so the primary food source of vitamin K2 is fermented foods such as natto, a fermented soy product typically sold in Asian grocery stores. Fermented vegetables can be a great source of vitamin K if you ferment your own using a specially-designed starter culture. My Kinetic Culture is high in strains that make vitamin K2. If you would like to learn more about making your own fermented vegetables with a starter culture, you can watch the video and read more on this page.

Please note that not every strain of bacteria makes K2, so not all fermented foods will contain it. For example, most yogurts have almost no vitamin K2. Certain types of cheeses, such as Gouda, Brie, and Edam, are high in K2, while others are not. It really depends on the specific bacteria. Still, it’s quite difficult to get enough vitamin K2 from your diet—especially if you do not eat K2-rich fermented foods—so taking a supplement may be a wise move for most people.

How Can You Tell if You’re Deficient in Vitamin K2?

The major problem we face when it comes to optimizing vitamin K2 is that, unlike vitamin D, there’s no easy way to screen or test for vitamin K2 sufficiency. Vitamin K2 cannot at present be measured directly, so it’s measured through an indirect assessment of undercarboxylated osteocalcin. This test is still not commercially available, however. “That’s our problem. If that was available, we could start testing and showing people that their levels are low,” Dr. Goodman says.

Without testing, we’re left with looking at various lifestyle factors that predispose you to deficiency. As a general rule, if you have any of the following health conditions, you’re likely deficient in vitamin K2:

That said, it’s believed that the vast majority of people are in fact deficient these days and would benefit from more K2. One reason for this is very few (Americans in particular) eat enough vitamin K2-rich foods. So, if you do not have any of the health conditions listed, but do NOT regularly eat high amounts of the following foods, then your likelihood of being vitamin K2 deficient is still very high:

  • Certain fermented foods such as natto, or vegetables fermented using a starter culture of vitamin K2-producing bacteria
  • Certain cheeses such as Brie and Gouda (these two are particularly high in K2, containing about 75 mcg per ounce)
  • Grass-fed organic animal products (i.e. egg yolks, butter, dairy)

Different Kinds of Vitamin K2

The vitamin K puzzle is even more complex than differentiating between K1 and K2. There are also several different forms of vitamin K2. The two primary ones—and the only ones available in supplement form—are menaquinone-4 (MK-4) and menaquinone-7 (MK-7). MK-4 has a very short biological half-life—about one hour—making it a poor candidate as a dietary supplement. MK-7 stays in your body longer; its half-life is three days, meaning you have a much better chance of building up a consistent blood level, compared to MK-4.

In supplement form, the MK-4 products are actually synthetic. They are not derived from natural food products containing MK-4. The MK-7– long-chain, natural bacterial-derived vitamin K2– on the other hand comes from a fermentation process, which offers a number of health advantages.

Research4 has shown MK-7 also helps prevent inflammation by inhibiting pro-inflammatory markers produced by white blood cells called monocytes. MK-7 is extracted from the Japanese fermented soy product natto, and since it’s longer lasting, you only need to take it once a day. With an MK-4 supplement, you need to take it three times a day. The duration of action is also much longer with MK-7.

As for a clinically useful dosage, some studies have shown as little as 45 micrograms per day is sufficient. Dr. Goodman recommends taking 180 micrograms per day, making sure the K2 is in the form of MK-7. If you’re eating natto, all you need is about one teaspoon.

That said, vitamin K2 is non-toxic, so you don’t need to worry about overdosing if you get more. Do keep in mind that vitamin K2 may not necessarily make you “feel better” per se. Its internal workings are such that you’re not likely to feel the difference physically. Compliance can therefore be a problem, as people are more likely to take something that has a noticeable effect. This may not happen with vitamin K2, but that certainly does not mean it’s not doing anything! Last but not least, remember to always take your vitamin K supplement with fat since it is fat-soluble and won’t be absorbed without it.  Read More

Medical Document Services of Kansas, LLC (MDS) is a Wichita, Kansas healthcare document service specializing in Medical Billing and RCM, Medical Transcription, Pre-Certs with AzaleaHealth EHR.   We provide efficient, accurate, affordable quality services for hospitals, clinics, and facilities of all sizes. Call 866-777-7264 today, or visit our website for more information.  We have education programs in Medical Scribe Specialists. #medicaltranscription #azaleahealthEHR #revenuecyclemanagement #MDSofKansas #medicalbillingservice


Scribes Can Alleviate Doc Burnout

Certified Medical Scribe Support Can Alleviate Physician EHR Burnout Concerns; Certify Today

CONTACT: Kristin Hagen
President/CEO, American College of Medical Scribe Specialists
(657) 888-2158

ORANGE, CA., July 6, 2016. According to a new analysis by the Mayo Clinic and American Medical Association researchers of a nationwide survey of physicians, computerized provider order entry and electronic health record use are a major source of burnout for physicians. The study found that physicians who used EHRs and CPOE had greater rates of burnout than those who did not, an issue that Certified Medical Scribe Specialists (CMSS) have been shown to help alleviate.

“This study makes it clear that physicians are frustrated with the drop in productivity resulting from electronic health record use and the time takes away from true, face-to-face interactions with patients,” said ACMSS Executive Director Kristin Hagen. “The revolution in our healthcare system toward value-based, individualized medical care and treatment cannot happen if the EHRs meant to help facilitate these changes are a major source of physician dissatisfaction. Certified Medical Scribe Specialists assist practices and clinicians in real time, assisting innovative workflow and efficiencies, providing necessary tools and resources.”

A study published last fall in ClinicoEconomics and Outcomes Research found that physician productivity in a cardiology clinic was 10% higher for physicians using medical scribes. This improved productivity resulted in 84 additional new and 423 additional follow-up patients seen in one year. That study also found that the physicians using medical scribes finished most or all of their work during clinic hours and they did not have to spend additional time to complete documentation after their standard working hours.

“The clinical documentation and practice efficiencies certified scribes provide have been shown to ease the clerical burdens of CPOE and EHRs, and give physicians back the time and attention they need focus on their patients,” Hagen said. “Providers need to ensure that they use certified medical scribes, meeting CMS requirements, revolutionizing clinical care and creating sustainable outcomes together.”

The ACMSS certification program meets current and proposed CMS certification requirements toward use of electronic health records. ACMSS works in compliance with CMS to meet national goals and initiatives of Meaningful Use, Merit-Based Payment Incentive System (MIPS) and Medicare Access and CHIP Reauthorization Act (MACRA).  Certified medical scribes also meet the “qualified people” standard in Certified Electronic Health Record Technology (CEHRT).  If not the clinicians themselves entering the data, eligible personnel must be certified, meeting the CEHRT Meaningful Use (MU) Personnel standard.

The ACMSS certification program meets current and proposed CMS certification requirements toward use of EHRs through its Medical Scribe Certification & Aptitude Test (MSCAT). ACMSS provides specialty certifications in vascular medicine, dermatology, oncology, primary care, internal medicine, emergency medicine and general patient care, enabling access to all across the specialities. ACMSS enables same-day certification for practices to meet Meaningful Use attestations, presently at 2%, and offers ongoing webinars to assist prospective individuals with key information about ACMSS, regulations, and innovations to meet healthcare goals through Volume Certification Packages.

Building integrative systems design for prevention and disease reversal for patient care most heavily impact family practice, primary care, and urgent care, followed by all the specialities. MIPS and MACRA allow the current traditional healthcare system and providers to focus on their much-needed goals today in independent practices of working to assist patients in disease reversal and prevention toward wellness.

The American College of Medical Scribe Specialists offers five separate pathways for Certified Medical Scribe Specialists. Please contact ACMSS directly atsupport@theacmss.org or 657-888-2158 if you have any questions regarding the ACMSS program and/or materials.


The American College of Medical Scribe Specialists is the nation’s only nonprofit professional society representing more than 17,000 Medical Scribes in over 1,700 medical institutions. ACMSS partners with academic institutions, non-profit partners, and medical scribe corporations to offer both education-to-certification and employment-to-certification pathways. ACMSS advances the needs of the medical scribe industry through certification, public advocacy, and continuing education. To learn more about ACMSS, please visit: theacmss.org

(657) 888-2158


Certified Medical Scribe Specialists (CMSS) credentials and certification are enabled via the Medical Scribe Certification & Aptitude Test (MSCAT), recognized by CMS, meeting the Personnel Measure of Eligible Personnel of “who” may document in the EHR.

Medical Document Services of Kansas, LLC (MDS) is a Wichita, Kansas healthcare document service specializing in Medical Billing and RCM, Medical Transcription, Pre-Certs with AzaleaHealth EHR.   We provide efficient, accurate, affordable quality services for hospitals, clinics, and facilities of all sizes.   Call 866-777-7264 today, or visit our website for more information.  We have education programs in Medical Scribe Specialists. #medicaltranscription #azaleahealthEHR #revenuecyclemanagement #MDSofKansas #medicalbillingservice

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Transcription Market Share Analysis

Lower Volumes, But More Stable Outlook

JOHNSON CITY, TN — Of the estimated 2.1 billion patient encounters documented in the United States in 2015, approximately 32%, or over 670 million documents, were generated by dictation and transcription, according to a new market analysis from WebChartMD.

The analysis (click here to access) breaks out the clinical documentation market into the three main documentation methods most often used by healthcare providers: 1) Provider Entry, in which the healthcare provider enters data him/herself into the EHR; 2) dictation and transcription; and 3) Scribe Entry, in which Medical Scribes enter data into the EHR.  Front-end speech recognition usage was not included in the study.

Provider Entry is the leading clinical documentation method, with an estimated 61% market share, followed by dictation and transcription, with an estimated 32%. Scribe Entry trails with an estimated 7% market share.

Dictation and transcription, the second most-used modality, had its heaviest concentration of usage in ambulatory specialty care and hospital-based documentation.  The medical transcription industry had estimated 2015 sales of $2.2 billion, or 20.6 billion annual lines. About 30% of all US-based physicians – or just over 300,000 – continue to use dictation and transcription for some percentage of their clinical documentation, according to a recent WebChartMD estimate.

A notable change in the break-out of market share has been the rise of the Scribe Entry segment, which has grown from a few thousand to over 20,000 Scribes nationwide in just the last few years. Scribes currently process an estimated 143 million patient encounters annually, or about 7% of the entire clinical documentation market.

One take-away from the analysis? “The government has spent billions of dollars since the 2009 HITECH Act to incent physicians to adopt EHR-based clinical documentation tools.  Despite that, there remains a sizable minority of healthcare providers who continue to use dictation and transcription,” said Christensen. “While transcription will never return to its former levels of usage, I believe there are a number of specific reasons why it will persist as a clinical documentation modality.”

About WebChartMD

WebChartMD, a software development company specializing in clinical documentation workflow applications, partners with over 100 MTSOs nationwide, which in turn serve over 8,000 physicians via the WebChartMD platform. 

Medical Document Services of Kansas, LLC (MDS) is a Wichita, Kansas healthcare document service specializing in Medical Billing and RCM, Medical Transcription, Pre-Certs with AzaleaHealth EHR.   We provide efficient, accurate, affordable quality services for hospitals, clinics, and facilities of all sizes. Call 866-777-7264 today, or visit our website for more information.  We have education programs in Medical Scribe Specialists. #medicaltranscription #azaleahealthEHR #revenuecyclemanagement #MDSofKansas #medicalbillingservice

Highlights From The 2016 State of The Medicine Address

GomerBlog highlights the major points from tonight’s State of The Medicine Address given by the President of Hospital Administrators, Mr. Cutter Salary.

  • Hospitals now have the highest patient satisfaction in the history of healthcare and probably correlates to increased quality of care according to patients and lawmakers
  • WiFi, fast food restaurants, and pianos are distributed throughout hospital lobbies replacing exam rooms and useless medical equipment
  • Doctors now spend 50% of their time coding which is a vast improvement over last year and has led to spectacular reimbursement rates to enable hiring of more administrators. Remember Caring IS Coding!
  • Drinks were finally stripped from the Nursing Station. This year we must continue with stripping any fun or laughter from the Station.  We don’t want our patients thinking we are making fun of them
  • Breaks are vanishing from the workplace and we need to continue that for our medical providers. Foley catheters were distributed to staff to help our providers perform flawless and uninterrupted care
  • Surgeons are required to perform 3 more surgeries a day and leave when it is dark outside. Skin cancer rates are drastically down in our employees now thanks to this move.
  • Patient to Nurse ratios are at an all-time high providing a challenging and dynamic work environment to our nursing staff, which we know they enjoy
  • The new Secretary of The Medicine, Dr. Oz, continues to utilize his charismatic charm to educate the public before they come to the hospital
  • And finally, our budget has been passed and includes hiring another 1.2 million hospital administrators to oversee and provide outstanding medical care to our hospitals!
  • “God Bless The Medicine and God Bless my obnoxiously large pension!”


Medical Document Services of Kansas, LLC (MDS) is a Wichita, Kansas healthcare document service specializing in Medical Billing and RCM, Medical Transcription, Pre-Certs with AzaleaHealth EHR.   We provide efficient, accurate, affordable quality services for hospitals, clinics, and facilities of all sizes. Call 866-777-7264 today, or visit our website for more information.  We have education programs in Medical Scribe Specialists. #medicaltranscription #azaleahealthEHR #revenuecyclemanagement



Everywhere you look now, a telehealth stat or strategy is being written about or discussed. I realize not in every instance but in many where they are discussing evolutions in care coordination, improving outcomes, increasing patient satisfaction and certainly driving additional (and much needed) revenue.telehealth-image-300x201

Here are some of the recent news clips:

  • Primary care continues to see a boom in telehealth implementation with the infusion of non-traditional healthcare players such as Apple, Walmart, Walgreens, etc. into the space, which will continue
  • Since the ACA, remote patient monitoring has arisen as a method to reduce hospital readmissions and curb costs for providers. Many hospitals have sent patients home with remote monitoring devices so they can be observed at home for the post-30-day period and this method has saved money and reduced readmissions penalties drastically in some cases
  • Post-acute providers and hospitals have been more engaged in integrating telehealth into their services because they see the benefits as far as cost-savings and lowering readmissions

No matter the size of your hospital, surgery center, clinic or practice, you may want telehealth on your radar screen.

While potential costs are mentioned as a barrier (or excuse not to research), telehealth can be extremely affordable and simple to implement. The real “costs” may come when practices, hospitals and other organizations lose out on the additional revenue, care quality and incentives that come along with telehealth strategies.

There are even integrated solutions that exist today that place telehealth on provider desktops, tablets, and smartphones, enabling face-to-face video communications integrated into their clinical workflow that are as easy as a phone call to initiate or receive. Experts also suggest the fast growth of consumerism in healthcare as well as the increased use of mobile health applications will further promote telehealth strategies from the patient engagement perspective as patients seek to manage and coordinate their own care.

Here are a few strategies and best practices for investing in telehealth

Protect your market share. All but three states reimburse for telehealth encounters for their Medicaid programs, and 27 states have enacted laws that enforce coverage for services provided through telehealth. Although it is not mandated, many private insurers offer reimbursement for services delivered through telehealth.

Proposed rules for Meaningful Use Stage 3 treat a real-time patient encounter delivered through technology-assisted healthcare the same as a physical encounter. What’s more, the provider can also choose to include consultative services “such as reading an EKG, virtual visits, or asynchronous telehealth.”

The payer community has embraced telehealth to help patients receive the right care at the right time. Providers should do the same.

Increase revenue. Remote monitoring for patients with two or more chronic conditions not only can help patients live with their conditions more effectively, it also can increase the bottom lines of providers. The Centers for Medicare & Medicaid Services has developed CPT codes that allow providers to bill a monthly fee for monitoring patients with chronic illnesses.

CPT code 99490 allows for non-face-to-face care coordination services for those with a care plan listing multiple chronic conditions expected to last at least 12 months and place the patient at significant risk of death or decline. Average compensation is $42.60 monthly, based on geography. It can be used in conjunction with CPT code 99091 (collection and interpretation of physiologic data) for a $56.92 monthly reimbursement per patient.

Prepare for the future. The telehealth and home health technologies market is expected to quadruple in size over the next five years, growing to $13.7 billion by 2020, according to a market intelligence company that tracks the space with other reports predicting much higher growth.

Once considered a fringe technology, telehealth clearly has moved into the mainstream as a way to see patients who may be limited by mobility or geography, as well as those who prefer the convenience of a face-to-face video encounter. Another important use case that is growing is for provider-to-provider such as a primary care provider collaborating or coordinating care with a specialist locally or halfway around the world.

As many industry leaders and even disrupters are suggesting, organizations need to invest in telehealth phenomenon to effectively compete in the healthcare marketplace. But in order to truly fulfill its mission, telehealth must be convenient to providers. Any telehealth solution must be readily available, incorporated into the natural workflow of the provider and available on the device he or she uses.  Read more…

Baha Zeidan is the co-founder and chief executive officer of Azalea Health Innovations.AzaleaHealth_1000px_002






Medical Document Services of Kansas, LLC (MDS) is a Wichita, Kansas healthcare document service specializing in Medical Billing and RCM, Medical Transcription, Pre-Certs with AzaleaHealth EHR.   We provide efficient, accurate, affordable quality services for hospitals, clinics, and facilities of all sizes. Call 866-777-7264 today, or visit our website for more information.  We have education programs in Medical Scribe Specialists. #medicaltranscription #azaleahealthEHR #revenuecyclemanagement


Health & You: Chemotherapy and Swimming


Chemotherapy is a cancer treatment that uses chemicals to blast cells. It’s not a blast of radiation, but a chemical treatment that targets cancer cells.

Chemotherapeutic agents kill cells that quickly divide – such as cancer cells. How do infections and chemotherapy and swimming all relate?

  1. Chemotherapy
  2. Chemotherapy and Infection Risk
  3. Chemotherapy and Swimming


For over 50 years, chemotherapy or ‘chemical therapy’ has been a part of cancer treatment. Chemotherapy injections or pills can be used by itself or in addition to surgery or targeted radiation treatment. Surgery and radiation destroy the cancer cells in a given region, while chemotherapy works well throughout the body.

Cancer cells multiply at a quicker rate than normal cells; therefore chemotherapy is made to target multiplying cells. The more they divide, the stronger the effectiveness of the drug will be.

With chemotherapy comes the side effect of normal cells being destroyed as well. These cells can be found in the hair, mouth and intestines. Side effects of chemotherapy include exhaustion, mouth sores, nausea, hair loss and brittle nails.

Additionally, the immune system can become weakened which allows for more infections. Because of these risks and side effects that accompany chemotherapy, many patients can be devastated with the option of chemotherapy.

Cancer treatment in many cases requires the use and access of veins for different options for treatments – including chemotherapy, blood transfusions, antibiotics and intravenous fluids, or IV fluids. To make procedures and treatments such as these easier, doctors might recommend using a catheter or port, however these present another infection risk.

blue-crossCancer and Infection Risk

Infection occurs when germs are allowed to enter an moist opening on the body, multiplying and mutating. This is common with those who suffer from cancer, as the immune system is in a weakened state. Fortunately, there are many ways to prevent and treat possible infections.

Catheters are long plastic tubes that deliver treatments and drugs that can manage side effects and symptoms of cancer directly into a vein. Washing hands before you touch the catheter helps prevent infection. Germs from dirty hands can lead to germs getting into your system, which is worse when the immune system is weakened.

Other helpful tips include changing the bandages when necessary – as germs can build up on an old bandage. Prevent air from getting in the catheter by making sure the clamps are tight when the tube isn’t in use. Avoid breaks or cuts in the catheter, and keep the catheter from being underwater.

After a chemotherapy treatment is when one is most vulnerable to infectious disease. Viral infections like influenza or the common cold are easily transferred from person-to-person in crowded areas. Some ways to help prevent infection include washing hands often and avoid touching hands to mouth or eyes.

Mouth care is also important; keep the mouth clean by brushing teeth twice a day; use mouth rinses without alcohol, and do not use floss. Food safety is important as well – and it is even more vital during chemotherapy to remember tips you follow as usual such as washing hands before preparing and consuming food, cooking food well, keeping raw foods away from ready-to-eat food, wash vegetables and fruits, and keep cold food cold.

On a related note, those at highest risk for infection shouldn’t drink water that is not properly treated. Boiling water for a full minute kills cryptosporidium and other waterborne organisms.

Pay attention to white blood cell counts during cancer treatment. Your health care professional should let you know when you receive a treatment that will lower your white blood cell count, and you should ask when white blood counts are going to be at their low point, when your body will be less likely to fight off infection.

blue-crossChemotherapy and Swimming

The American Cancer Society’s message regarding exercise is clear – moderate exercise during treatment is beneficial. Chemotherapy’s side effects can reduce the motivation to exercise for some patients, though it is important to keep as active as possible. Why? Exercise can actually increase effectiveness of cancer treatment, boosting odds of survival. There are other advantages to exercise – a 1999 study showed that there was a significant decrease in fatigue among chemotherapy patients, and that there was an indication of less fear, anxiety and other psychological distress overall.

Swimming can cause accidental ingestion of water and can therefore increase the chances of obtaining cryptosporidium or other waterborne pathogens. It is important to make sure to avoid situations where you find yourself inhaling environmental spores found in and around moist, dark areas such as rotting leaves and compost piles. Public hot tubs and spas are not recommended because there are some bacteria that can survive in the warmer water. However, if the hot tub is disinfected properly, there is little to no risk.

Swimming pools and hot tubs are not the only risk – swimming in lakes, rivers and oceans can bring on recreational water illnesses. These can be spread from swallowing, inhaling and contacting contaminated waters with open eyes, or open cuts or sores. The most common recreational water illness is diarrhea. Other illnesses from contaminated water include gastrointestinal, skin and mild respiratory infections.

Pools and hot tubs that are disinfected properly can be a safer swimming experience, especially low-use residential pools – but pH and disinfectant levels should be checked on a frequent basis for disease-causing germ control, and the water should be over-filtered, with long daily filter runs.

In many cases, chemotherapy patients are fitted with a port-o-cath for injections. Cover a catheter or central line with a suitable water barrier like a Tegaderm and tape over the area fully before swimming, and change bandages after each swim.

The take-home from this is to be sure to bring up these points with your doctor. Ask about your specific case, and if swimming and/or hot tubs should definitely avoided altogether. All cancer cases and infection susceptibility vary so it is important to communicate at various stages with your doctor about when swimming during chemotherapy is beneficial or best avoided – for you.

Get your Swim On, America

Dr. Pool


“Catheters and Ports in Cancer Treatment.” Cancer.Net. N.p., n.d. Web.

Patural, Amy. “Chemotherapy 101 – Cancer Treatment.” EverydayHealth.com. N.p., 16 Feb. 2010. Web.

“Infection.” – Managing Side Effects. N.p., n.d. Web.

Facey, Dorian. “Exercise During Chemotherapy.” LIVESTRONG.COM, 21 Oct. 2013. Web.

Millehan, Jan. “Swimming & Chemotherapy.” LIVESTRONG.COM, 19 Feb. 2014.Web.

Medical Document Services of Kansas, LLC (MDS) is a Wichita, Kansas healthcare document service specializing in Medical Billing and RCM, Medical Transcription, Pre-Certs with AzaleaHealth EHR.   We provide efficient, accurate, affordable quality services for hospitals, clinics, and facilities of all sizes. Call 866-777-7264 today, or visit our website for more information.  We have education programs in Medical Scribe Specialists. #medicaltranscription #azaleahealthEHR #revenuecyclemanagement


mds-ascAnnie Martinez writes a great article for Dummies.com titled Ten Myths About Medical Transcription. Clearly there has been much confusion about our profession over the last few years, and she puts in all in perspective.  We have been bullied to believe that transcription is being replaced by technology or going overseas, and we have certainly seen some of that occur.  Although in recent years, we have seen much more come back.   Annie clearly outlines Transcription is back, here to stay, and as important as it was 20 years ago.


Ten Myths about Medical Transcription

There’s a lot of misinformation floating around about the ins and outs of a medical transcription career. Some of it comes from honest misconceptions; the rest comes from training companies that want your money.

Medical transcription (MT) is interesting and challenging. You can train from home and work from practically anywhere you can get an Internet connection. There are opportunities to work nontraditional hours, part-time or full-time, as an employee or as self-employed independent contractor. MT has a lot going for it. It isn’t, however, a free ticket to prosperity with no strings attached.

Medical transcriptionists make $50,000 a year working from home

This particularly alluring myth frequently appears in advertisements promising to take you from zero to medical transcriptionist in a matter of months — just come to our free seminar to find out how! Don’t believe it, and don’t sign up for training (or even attend a seminar) from any company that makes such a claim.

Are there medical transcriptionists who make $50,000 a year? Yes, but they’re few and far between. A quick trip to the U.S. Bureau of Labor Statistics (BLS) website reveals that the average annual salary for a full-time medical transcriptionist is closer to $34,000.

Medical transcriptionists can work and take care of the kids at the same time

If you’re picturing yourself tapping away at the keyboard while your little darling plays quietly at your feet, pinch yourself and wake up! There’s no way you can transcribe medical reports and take care of children at the same time.

MT work requires intense concentration and undivided attention, two things that aren’t compatible with supervising little ones (or much of anything else). If you have young children at home, you’ll need to arrange for childcare during your work hours or work while they’re sleeping.

Medical transcriptionists just need to type really fast

The ability to type at warp speed is a great asset, but it isn’t an automatic ticket to success as an medical transcriptionist. The things that really make the difference are largely mental:

  • An inquisitive mind and love of language so you can learn (and keep learning) all those medical terms

  • An independent, pressure-resistant mindset

  • The ability and motivation to concentrate intently for extended periods of time

Medical transcriptionists need little or no training

Unless you have formal medical transcription training, your résumé will never make it into the “to interview” stack. The training must be from a recognized, reputable source, such as a community college program or well-established medical transcription school. Otherwise, you’re toast.

Plan on spending a bare minimum of nine months preparing for your new career. You’ll study anatomy and physiology, medical terminology, formatting of the different report types, and many more skills you may not anticipate needing but definitely will. When you graduate, you’ll have that crucial formal training to include on your résumé and the know-how to do the job.

Speech recognition technology will make medical transcriptionists obsolete

Speech recognition technology (SRT) is in widespread use as a way (in theory) for medical facilities to cut transcription costs. Working medical transcriptionists refer to it as “speech wreck,” because the results sometimes have more in common with a multicar pileup than a quality healthcare document. Under ideal dictation conditions, SRT can do a decent job, but it takes very little to send things awry.

Despite its substantial shortcomings, SRT seems to be here to stay. Because the results of SRT are unreliable and require constant supervision, it now figures into what medical transcriptionists do on a daily basis. Speech recognition has added a fresh twist to the ever-evolving MT profession, not made it obsolete.

Electronic health records will eliminate the need for medical transcriptionists

This is only true in the minds and marketing materials of people who sell EHR software. Somewhere along the way, the idea of digitizing medical information seems to have become equated with transforming the recording of healthcare details into an entirely point-and-click process, but it’s increasingly evident that it can’t be done.

Some elements of healthcare documentation are enhanced by restricting input via check boxes and drop-down lists, but for some things, fill in the blanks just doesn’t cut it. Healthcare providers need a way to incorporate narrative observations, opinions, and conclusions — in other words, dictation.

Most medical transcription work is being outsourced overseas

Everything else seems to be going to cheaper, offshore workforces — why not medical transcription? After all, who can afford to pass up a chance to save some green? Medical transcription began going abroad in the 1990s, and more was headed that way, but then things changed.

In 2010, changes in federal laws related to protecting patient health information made compliance with federal Health Insurance Portability and Accountability Act (HIPAA) rules an even higher priority for medical transcription companies and healthcare facilities. In order to achieve tighter control over patient information, it’s being kept closer to home.

Getting certified is the best way to break into medical transcription

Any advertisement that entices you to “become a certified medical transcriptionist” is feeding you a line of hogwash. You don’t need a certification or a license to become a medical transcriptionist. There is a Certified Medical Transcriptionist (CMT) credential, but it’s not an entry-level kind of thing, and no training program can give it to you.

You may opt to earn it eventually, but you’ll need at least two years of experience under your belt first. Even then, you’ll have to pass a rigorous exam that will test your medical knowledge and transcription skills across multiple medical specialties.

Medical transcription is low-stress work

You may think medical transcription is a low-pressure job. How hard can it be to listen to what somebody says and type it up in a report? A lot harder than you can ever imagine until you’ve actually done it. You’ll be astounded by what comes across your headphones — guaranteed!

For starters, medical dictation often arrives amply stocked with background noise and interruptions — and don’t forget the crackers (dictators seem to frequently have a mouthful of them). It includes words you haven’t ever heard before and have no idea how to spell, especially at first. Many times, a thick foreign accent will be slathered on top. So, let’s just say the clarity isn’t always the best. . . .

Real men don’t become medical transcriptionists

Okay, maybe nobody says that, but you may get that impression when researching the field. The current crop of medical transcriptionists is overwhelmingly female, but men and women are equally capable of becoming excellent medical transcriptionists.

It’s not any harder for a man to break into the field than it is for a woman. As more men seek out work they can do from home or on a flexible schedule, they’re discovering medical transcription. Medical transcriptionist employers care how many reports you can produce, how fast, and how accurately.

Medical Document Services of Kansas, LLC (MDS) is a Wichita, Kansas healthcare document service specializing in Medical Billing and RCM, Medical Transcription, Pre-Certs with AzaleaHealth EHR.   We provide efficient, accurate, affordable quality services for hospitals, clinics, and facilities of all sizes. Call 866-777-7264 today, or visit our website for more information.  We have education programs in Medical Scribe Specialists. #medicaltranscription #azaleahealthEHR #revenuecyclemanagement

AHDI Shares Some Great Articles on EHR, patients recording their visits, and ICD-10 … see what you think!

Doctors beware: The EHR debacle may get much worse
American Thinker
More and more people are having the disturbing experience of seeing their doctors spend more time pecking at a computer keyboard than examining them. The doctors are entering data into their patients’ electronic health records in compliance with federal rules introduced a few years ago. EHRs drive doctors crazy. Their own experience tells them that electronic recordkeeping interferes with care, by taking time away from patients.


Patients press the ‘record’ button, making doctors squirm
Washington Post
According to author Christie Aschwanden: My dad had a health scare recently, and at a doctor’s appointment to receive some important test results, my mom wanted to record audio of the visit on her smartphone. “If he had gotten some terrible diagnosis, I wanted to be able to share that discussion with you and your sister,” Mom told me later. But when she asked if it was okay to record, the doctor replied, “No. I don’t want you to do that.”

Senator blasts EHR program
Healthcare IT News
Until physicians have EHRs that can talk with one another, the Precision Medicine Initiative introduced by President Barack Obama could be in jeopardy, Sen. Lamar Alexander said. “We’ve got to get these records to a place where the systems can talk to one another — that’s called interoperability — and also where more doctors, particularly the smaller physicians’ offices, want to adopt these systems, can afford the cost and can be confident that their investment will be of value,” Alexander said.


ICD-10 bill surfaces, calls for delay, more study of rollout disruptions 

Healthcare Finance News
Text of a bill by Rep. Ted Poe to delay the switch to ICD-10 diagnostic coding surfaced recently, in which it requests further study on the disruption on healthcare providers could face resulting from the replacement of ICD-9. The three-page bill, H.R. 2126, was proposed on April 30 but the text was not posted for over a week. The bill would prohibit the Secretary of Health and Human Services from replacing ICD-9 with ICD-10 on Oct. 1, as is scheduled.


Almost 90 percent of healthcare providers hacked in last 2 years
Slash Gear
Cyber attackers have increasingly turned their attention to healthcare providers, of which nearly 90-percent were hacked over the course of the last two years. The growing number of cyber attacks against the healthcare industry is said to cost $6 billion annually, marking a trend where hackers shift focus from financial institutions and retailers to those with medical records. All in all, these attacks are said to have doubled in the United States over the last half decade.


CMS promotes ICD-10 readiness with more end-to-end testing
RevCycle Intelligence
There are 142 days left until the International Classification of Diseases — ICD-10 — compliance. What’s next? More Medicare end-to-end testing efforts, says The Centers for Medicare & Medicaid Services. CMS has announced via email announcement a final opportunity for a sampling of volunteers to conduct ICD-10 end-to-end testing. From July 20 through July 24, 2015, the sample group will conduct testing with Medicare Administrative Contractors and the Common Electronic Data Interchange contractor.


Could high-tech health record solutions lead to less expensive healthcare?
Government Technology
Imagine if you never had to fill out another patient information form at a doctor’s office again. That’s the promise of a new portable patient health record service developed by Boca Raton-based InfoPeHR. For $35, patients can buy a credit card-sized USB drive that can hold their records — including high-resolution medical images — for a lifetime, said InfoPeHR owner Bernard Brigonnet.


Misuse of EHR systems and medical errors
EHR Intelligence
Does EHR technology reduce the likelihood of medical errors throughout the healthcare continuum? The input from medical professionals answering this question is mixed. There are certain mistakes that were tied directly back to the misuse of EHR or e-prescribing systems. As previously reported, one pharmacist had ordered acetaminophen for the wrong patient because they had two records open at the same time.


EHR alerts increase HPV vaccine rates 10 times over
Health IT Analytics
EHR alerts that help providers remember to start or complete the HPV vaccine for pediatric patients have significantly increased the rate of protection against cervical cancer. Patients between the ages of 9 and 18 were three times more likely to start the vaccine series and 10 times more likely to finish the entire course when EHR alerts were available to their primary care providers, found a study published this month in the Journal of the American Board of Family Medicine.

Medical Document Services of Kansas, LLC (MDS) is a Wichita, Kansas healthcare document service specializing in Medical Billing and RCM, Medical Transcription, Pre-Certs with AzaleaHealth EHR.   We provide efficient, accurate, affordable quality services for hospitals, clinics, and facilities of all sizes. Call 866-777-7264 today, or visit our website for more information.  We have education programs in Medical Scribe Specialists. #medicaltranscription #azaleahealthEHR #revenuecyclemanagement

Retail Healthcare – What do you think?

Retail health clinics seeking telemedicine, mobile technology to grow presence

Retail giants Walmart and Target, and likely others, will continue their steady march into the healthcare setting, sensing an opportunity to leverage their customers with a mix of technology that could be a boon to the digital health space.

Speaking at Health 2.0’s WinterTech conference in San Francisco, officials with both companies said the move toward providing a deeper level of services, including some level of chronic disease management, could apply to both their employees and consumers, as part of a wider effort to contain healthcare costs and to guide consumers to healthier lifestyles.

“It is indeed a customer-facing retail clinic. However, it is also an on-site clinic for our employees,” said Ben Wanaker, who leads the Walmart Care Clinic business. “All of our employees have health needs, all are on high-deductible health plans and Walmart, like everyone else, is struggling with healthcare costs.”

Both Target, which made headlines recently with its collaboration with Kaiser Permanente in Southern California, and Walmart will be exploring technological tools to enhance efforts, which could range from partnerships and acquisitions on technologies like mobile coaching apps to telemedicine efforts.

“We’re working on our digital telehealth strategy,” Wanamaker said, though he did not provide a time line or further details. walmartclinic02

Eric Brotten, VP of consumer health and referral solutions for Optum, likewise said retail clinics will continue to evolve, and that Optum, a division of insurance giant UnitedHealthcare, will be on the lookout for technologies to bolster its offerings. From a payer standpoint, the idea makes a lot of sense, he said.

“The real goal of that is to provide care in a way that ultimately drives outcomes in a different care setting,” he said, noting that Optum runs about 20 retail clinics in Texas, Kansas and Nevada.

For Target, much of the expansion will come in the way of collaborations, with the Kaiser effort cited as an example that could be extended into other regions, according to Michael Laquere, senior buyer for pharmacy at Target.

“We very much take a partnership approach,” he said, adding it and other retailers have an opportunity to reach potentially millions of consumers. He also demonstrated Target’s new pharmacy prescription app, suggesting medication adherence could be assisted through retail health.

“This is a big step and a big investment,” he said. The app can help with dosage alerts, refills and take pictures to assist with transferring prescriptions. Target partnered with Mscrips on the app.

“We’re building this platform, so we’re looking at things like coaching tools, ways to connect with telemedicine, connecting with pharmacies in a more virtual way,” he said when asked what Target’s next moves into the digital health space might include. In addition, scheduling functionality for appointments is of interest.

“We’re really interested in technologies and applications that can help us deliver evidence-based primary care,” Wanamaker said of Walmart’s goals. “Whether that’s (electronic medical record) applications or applications that live in a provider or patient’s pocket. We care about the quality in our care but we also need to be very efficient.”

From a data standpoint, retailers could be sitting on potentially riveting customer information, particularity as it relates to buying pattens, a la Amazon, and health outcomes. If successfully harnessed, seeing what kind of food a customer with a health condition is buying could lead to suggestions that might improve health, or mitigate a chronic condition like Type 2 diabetes.

Yet the potential is not yet realized because of potential privacy issues and regulations, although the opportunity is there.

“It’s a huge opportunity, but it’s something that we have to be very careful about,” Laquere of Target said. “The key is being really transparent and really clear about how we’re using the data and that it actually adds value.”

Wanamaker of Walmart agreed, within the regulatory constraints

“We think we have a tremendous opportunity that can help consumers make better decisions.”

While the retail sector sees opportunity in healthcare, Wanamaker said it’s unreasonable to suggest Walmart or Target would be the be-all, end-all for healthcare. But, he said, it could be a strong starting point for many people who struggle to access the healthcare system initially.

“We would never make the claim that we will be the beginning and the end of your healthcare needs,” he said. “However, not everyone gets to the beginning, and we want to be the beginning.

Medical Document Services of Kansas, LLC (MDS) is a Wichita, Kansas healthcare document service specializing in Medical Billing and RCM, Medical Transcription, and AzaleaHealth EHR.   We provide efficient, accurate, affordable quality services for hospitals, clinics, and facilities of all sizes. Call 866-777-7264 today, or visit our website for more information.  We have education programs in Medical Scribe Specialists and Healthcare Documentation Specialists. #medicaltranscription #azaleahealthEHR #revenuecyclemanagement

American doctors are ‘drowning in paperwork’

According to a new study, U.S. doctors spend nearly 17 percent of their working lives on nonpatient-related paperwork — time that might otherwise be spent caring for patients. The findings also suggest that the more time doctors spend on such tasks, the unhappier they are about having chosen medicine as a career


This data comes from new research conducted by Drs. Steffie Woolhandler and David Himmelstein, internists in the South Bronx who serve as professors of public health at the City University of New York and are lecturers in medicine at the Harvard Medical School. The results of the study were published in October by the International Journal of Health Services.

The authors of the study analyzed data from the 2008 Health Tracking Physician Survey (the most recent data available) that collected information from a national sample of 4,720 physicians practicing at least 20 hours per week. The researchers determined that an average doctor spends more than eight hours per week performing administration functions.

However, of note is the fact that this does not include time spent performing patient-related tasks like writing chart notes, communicating with other doctors and ordering labs. Specifically, administrative tasks are defined as “billing, obtaining insurance approvals, financial and personnel management and negotiating contracts.”

Of the population surveyed, the doctors spent 168.4 million hours on these tasks in 2008. The authors estimate that the total cost of physician time spent on administration in 2014 will amount to $102 billion, and they pointed out that physicians who used electronic health records actually spent more time (17.2 percent for those using entirely electronic records, 18 percent for those using a mix of paper and electronic) on administration than those who used only paper records (15.5 percent).

“Although proponents of electronic medical records have long promised a reduction in doctors’ paperwork, we found the reverse is true,” the authors wrote.

The more time spent on these tasks meant physicians were less happy with their work than those who did less of this work. Psychiatrists spent the most time on administration (20.3 percent), followed by internists (17.3 percent) and family/general practitioners (17.3 percent). Pediatricians spent the least amount of time (14.1 percent) on nonpatient-related administrative tasks and also were the most satisfied group of doctors.

“While solo practice was associated with more administrative work, small group practice was not,”Woolhandler and Himmelstein concluded. “Doctors practicing in groups of 100 or more actually spent more time (19.7 percent) on such tasks than those in small groups (16.3 percent).”

They point out that the only previous nationally representative survey of this kind was carried out in 1995, and that study showed that administration and insurance-related matters accounted for 13.5 percent of physicians’ total work time. Other, less representative studies, also suggest the bureaucratic burden on physicians has grown over the past two decades.

“American doctors are drowning in paperwork,” said lead author Dr. Woolhandler. “Our study almost certainly understates physicians’ current administrative burden. Since 2008, when the survey we analyzed was collected, tens of thousands of doctors have moved from small private practices with minimal bureaucracy into giant group practices where bureaucracy is rampant.

“And under the accountable care organizations favored by insurers, more doctors are facing HMO-type incentives to deny care to their patients, a move that our data shows drives up administrative work. Administrative work consumes one-sixth of U.S. physicians’ working hours and lowers their career satisfaction.”

This study and its findings parallel that of another recent study in September that was conducted by The Physicians Foundation related to physician satisfaction with their careers. That study suggests that U.S. patients may face growing challenges accessing care if shifting patterns in medical practice configurations and physician workforce trends continue.

According to the study, titled “2014 Survey of America’s Physicians: Practice Patterns and Perspectives,” 81 percent of physicians describe themselves as either overextended or at full capacity, while only 19 percent indicate they have time to see more patients.

Of those physicians surveyed, 44 percent plan to take steps that would reduce patient access to their services, including cutting back on patients seen, retiring, working part-time, closing their practice to new patients or seeking nonclinical jobs, leading to the potential loss of tens of thousands of full-time-equivalents.

“America’s physician workforce is undergoing significant changes,” said Walker Ray, M.D., vice president of The Physicians Foundation and chair of its Research Committee. “Physicians are younger, more are working in employed practice settings and more are leaving private practice. This new guard of physicians report having less capacity to take on additional patients.

“These trends carry significant implications for patient access to care. With more physicians retiring and an increasing number of doctors, particularly younger physicians, planning to switch in whole or in part to concierge medicine, we could see a limiting effect on physician supply and, ultimately, on the ability of the U.S. healthcare system to properly care for millions of new patients.”

The survey is based on responses from 20,088 physicians across the U.S.

“The state of the physician workforce, and medicine in general, is experiencing a period of massive transition,” said Lou Goodman, Ph.D., president of The Physicians Foundation and CEO of the Texas Medical Association. “As such, the growing diversity of the physician workforce will reflect different perspectives and sentiments surrounding the state of medicine.

“While I am troubled that a majority of physicians are pessimistic about the state of medicine, I am heartened by the fact that 71 percent of physicians would still choose to be a physician if they had to do it over, while nearly 80 percent describe patient relationships as the most satisfying factor about practicing medicine.”  Scott E. Rupp  Monday, November 10, 2014

Read more

Medical Document Services of Kansas, LLC (MDS) is a Wichita, Kansas healthcare document service specializing in Medical Billing and RCM, Medical Transcription, and AzaleaHealth EHR.   We provide efficient, accurate, affordable quality services for hospitals, clinics, and facilities of all sizes. Call 866-777-7264 today, or visit our website for more information.  We have education programs in Medical Scribe Specialists and Healthcare Documentation Specialists. #medicaltranscription #azaleahealthEHR #revenuecyclemanagement

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