What happens when you mix your EMR, Evidence Based Medicine, and a little love? Apparently the greatest thing to happen to technology-friendly physicians, and patients too.
At Esse Health, as doctors examine a patient, they type information into a laptop computer. It works this way:
The doctor still makes a diagnosis, but the computer brings back information on tests that work, tests that don’t work, remedies that work, remedies that are used but don’t work, and even remedies that many doctors didn’t know would work.
For example, Willey showed the computer’s reply to a diagnosis of an ear infection that was caused by antibiotic-resistant bacteria. Conventional medicine says the most common antibiotic, amoxicillin, doesn’t work on resistant bacteria. But the information in the computer said studies had shown that doubling the dosage of amoxicillin would cure the infection and was safe.
In another instance, a patient with arthritis needed a pain reliever. The computer brought back several choices. This time, though, a colored bar appeared on the screen that said Cox-2 inhibitors, which are expensive and are suspected of causing heart problems, are no more effective against the pain than over-the-counter pain relievers.
The information is fed to the computer by a staff of medical professionals, including pharmacists and physicians, said Doerr. The first manual for the program started out at a few hundred pages and now is several thousand. However, computers hold that much information with little problem.
Since Esse physicians started using this program a few years ago, they’ve found that their use of generic drug prescriptions has jumped to 69 percent from 52 percent. Also, they say they’ve cut medical costs for patients by more than $1,200 per doctor per month by increasing the use of generic drugs and cutting down on tests and procedures that the science says generally don’t work or aren’t necessary.