I Hate EMR's
There. I said it. The bane of my existence, as a primary care physician, are the idiotic electronic medical records I have been forced to use. Lets see...I have mastered Epic, Point Click Care, All scripts, Practice Fusion, etc., etc. I can't even begin to remember all the different systems.
The one point that is glaringly clear, they have added pain, frustration, and increasing amounts of time. But none, I said none, have actually improved patient care. I have spent thousands of dollars and countless hours using electronic medical records. They have altered my work flow, disturbed my connection with my patients, and otherwise consumed more time than actual patient evaluations.
In case I haven't said it before on this blog, EMR's were one of the main reasons I decided to leave my traditional primary care office and start a a home based concierge practice. Even if I still had to participate in the folly of governmental mandates, I at least had more time to count my clicks and argue with my patients over signing up for the patient portal.
Meaningful Use, MACRA
I have fully complied with meaningful use and MACRA. I have received bonuses over the years. These payments were made on the back of my poor patients who had to suffer through the pointing and clicking.
I finally gave up. I stopped seeing outpatients this January and now do nursing home and hospice work only. I chart on the medical record in the nursing home which is owned by the facility, and thus I cannot submit any data. Medicare doesn't recognize the difficulty of this situation. Starting in 2020 they will cut my payments until they whittle off 10%. To start with.
The truth is, I really don't give a flying #$#@. As I have documented elsewhere, I no longer practice to make a living anyway. I have that covered. So if Medicare wants to cut my payments, so be it.
Have at it Medicare. I give up.
The Last Laugh
Since I was still seeing patients in 2017 and charting on my own EMR, I decided to try to comply with MACRA. I could submit at least one piece of data so that I could maintain current payment levels in 2019 for my nursing home billings. For the first year of MACRA, the bar is quite low.
My personal assistant convinced me to send in a whole 3 months of data.
Just in case, you never know.
I got a letter today from the EMR company. Apparently my data was good. Great even. I am going to get a 4% bonus above the baseline for 2019. This is more than I expected. I was just hoping not to be cut.
It's irony, isn't it? When I was working hard to meet the governments needs, I was barely getting by.
Now I have decided to give them the middle finger.
And I'm getting a 4% bonus.