To be sure, many of the mistakes doctors make when using electronic records are in line with the errors they might make using paper records, but the errors can pile up since doctors are often able to enter orders remotely without revisiting a patient or communicating properly with other doctors, says Farley.
Many hospitals also have no formal procedure in place for doctors to use to alert each other about possible glitches or safety issues they notice when using electronic records, says Farley. And Rosenau of the American College of Emergency Physicians says many hospitals using digital records meet regularly to discuss possible glitches and to make recommendations to vendors on ways to make programs more helpful for doctors.
Some hospitals are working to lower those costs by cutting down on the use of CT scans, which are relatively pricey and expose patients to potentially harmful amounts of radiation, and by finding new uses for less expensive technology like ultrasounds.
In October, ACEP released a list of five tests and procedures it says patients often do not need and suggested alternatives that can be more cost effective and come with fewer complications. The guidance calls for cutting back on the use of antibiotics for wound cleaning, catheters for stable patients and IV fluids for patients who can drink fluids by mouth.
Doctors first abide by the Hippocratic oath of doing no harm, says Rosenau. Sure, some cases can be resolved before a patient leaves the ER: A person with an infection gets put on antibiotics, a gash needs stitching and a broken arm needs a cast. Many conditions discovered in the emergency room require more monitoring and care than can be provided in the emergency room.
Emergency departments are required to care for patients whether or not they are able to pay. That means any questions about insurance and payment might not come until after a patient is in the clear. When the bill does come, it may very well be alarmingly large. If no break is offered, many patients are at least put on a payment plan that buys them more time to pay—and avoids the high interest charges that can hit consumers who put the bill on a credit card.
Indeed, many hospitals will put patients in touch with financial counselors who can set them up with financial assistance, payment plans or reduce what they owe, says Rosenau. About eight in 10 medical bills contain errors, estimates Pat Palmer, founder of Medical Billing Advocates of America, a group that helps patients lower their medical bills. Emergency rooms will often charge a premium for routine medical supplies like Tylenol, gloves and bandages, says Palmer, adding that many patients can get such charges removed from their bills.
There could be a clinic or urgent-care center down the street that is better equipped to treat your condition, meaning shorter wait times and a smaller bill. Certain less severe injuries and conditions, such as the flu, fever, rashes and minor cuts and bone fractures, can be treated at urgent-care centers, according to ACEP. Some less urgent conditions like bronchitis and ear infections can also be treated at other places like a walk-in clinic at a local pharmacy, says Hudson.
For patients in critical condition, this is literally a life or death situation. In an interview with Devenir entrepreneur, PetalMD co-founder Patrice Gilbert listed four technologies he believes are foes to the healthcare system: pagers, fax machines, phones and Excel. How can these dated technologies still be the norm in hospital settings?
Most hair salons have been offering online appointment booking for years, yet few physicians have followed suit. Of course, hospitals can hardly be blamed for this show of resistance. For their part, medical clinics are bursting at the seams, which makes it difficult to see the big picture. This whitepaper is for physicians who could benefit from a scheduling solution.
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People with emergencies are relying on fewer and fewer emergency departments, causing more overcrowded waiting rooms and longer wait times. Many hospitals and ERs schedule the largest number of their staff to be present Monday through Friday, 9 a.
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