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Life With a Gas Bubble

July 16, 2014
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Vitrectomy surgery has been an "eye opener" in terms of ARRA/MU adoption.

In my last blog, I related to the value of the senses, as I was about to face retinal surgery for a macular hole.  Well, I am now two weeks post-surgery, and finally back to blogging!  Retinal surgery is a challenge I hope few have to face.  It required being face down day and night for ten straight days!  The photo illustrates the furniture that gets you through the day – not the most comfortable thing for long periods of time.

They tell you it will be possible to read and do activities, but in reality, if you are far-sighted as I am, it’s difficult to focus without your glasses at such short distances!  Audio books were my salvation to pass the time! 

The procedure involves injecting a gas bubble in your eye to hold things in place.  Gravity forces the bubble to the back of your eye during the face-down time.  The bubble is gradually absorbed, and as it is, the bubble gets progressively smaller.  Right now, it is the size of a button, but right in my lower vision where you would read or see the keyboard – a nuisance but manageable.

Travel is restricted until the bubble completely dissipates, as the gas can cause undue pressure in the eye, resulting in blindness!  So, I am antsy to get past the bubble and return to normal activity.

While going through the process, I have gotten a huge dose of reality when it comes to ARRA/MU!  The retinal surgeon is part of a three-physician vitreous group that has no EMR, and still uses micro-cassette recorders for dictation, and transports patient charts between multiple locations.  A few minutes’ discussion with the office manager suggested that as long as the senior partner is around, there isn’t likely to be any change.  Something about “you can’t teach an old dog new tricks!” 

With office practices like this, is it any wonder the adoption rate for ARRA/MU compliance will take some time (61 percent according to an SK&A report).  The perception (and most likely the reality) is that adding an EMR will be unproductive and impact their time to get things done.  I suspect if one were to study office practices, the EMR vendors have had greater success with the “low hanging fruit.”  Setting up an EMR for a specialty practice is perceived by these practices to be more complicated, and thus the acceptance level is likely lower.

Similarly, the adaptation of speech recognition is lower, as their vocabulary is more specialized, and it may take time to “adapt” speech recognition to their practice.  Getting these practices to understand the economics of bringing transcription in-house and reducing transcription costs is a challenge.  Again, the perception is that their vocabulary is more difficult, and they are therefore more reliant on specialized transcriptionists. 

This “fear of the unknown” is an issue, and it will take considerable effort on the part of vendors to raise awareness and educate practices to overcome their reticence to adopt the technology.  I will get great satisfaction watching this practice go through the eventual adoption and learning curve over the next six months to a year!  Given how busy they currently are, it will be interesting to see the impact on patient satisfaction, based on a current average office visit wait time of two to three hours!

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Comments

Hi Joe,
Although the follow-up is a real challenge to get through, it sounds like your procedure went well. At HCI, we are all hoping you are back to normal soon and blogging even more. I have had similar experiences with my primary care doc, watching her shuffle paper records and faxing documents. She is convinced that the transition to an EHR would be more trouble than it is worth. Sometimes I think abut switching docs, but I think she is a good doc in other ways...