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Re: Developmental Screening and EMRs

Joseph Schneider wrote:
> That said, I think what we are doing in COCIT is trying to show which
> EMRs are friendly to pediatricians and pediatric care.

	Years ago, I was at one of the annual Friends of Children Fund
	donor meetings where we get brief access to the AAP 'management'
	in an effort to both learn about the AAP's programs as well as
	provide some feedback about how to improve it.  [Forgive me if
	I've mis-described the event.]

	I made a fairly impolitic stink (I know, hard to believe) about
	how disappointed I was with the AAP's lack of policy on
	immunization registries.  "The AAP should stand up and make it
	black-and-white about how registries should work and what can
	be expected from its members in order to participate.  Right
	now, the registries a punitive at best.  And don't work.
	Members have no idea where to turn."

	Someone fairly high up the ladder actually *produced* the
	official immsreg statement for me a week later.  Apparently,
	there had been on there all along.  I read it carefully.

	It was relatively clear, reasonable, and, obviously, completely
	useless in terms of impact.  PCC interfaces with almost 20
	registries registries and has had a hand in delivering some in
	different states.  The registries are, imo, largely a failure,
	with the onus remaining on the private-practice physicians and
	miles from where they could actually be *if someone were smart
	and organized about it*.  We have to treat each one quite
	differently because they've all designed their own fiefdoms with
	no understanding of the wheels that have been invented before
	them.  Oh, the horror stories we can tell...embarrassing.

	BTW, "years ago" is about 10.  It's not as though this was 2
	years ago and the changes just haven't come through.  As far as
	I can tell, each registry only gets worse with time.

	Anyway, I don't say any of this to pick on COCIT one bit.  Dr.
	Schneider's comments just reminded me that the cows are already
	long out of the barn.  I agree with him that picking one EMR
	will *never* work.  Why hasn't any one EMR captured the market
	or anything close?  Because there isn't one that even approaches
	satisfaction for anywhere close to majority of users.  For every
	happy EMR practice, I can line up two unhappy ones for the same
	vendor.  [I'm not encouraging any commercial statements here.]
	I've been going to AAP events for, yeesh, 16+ years now and
	everytime an EMR appears [how many have come and gone...whew],
	one of our clients will tell me, "That's it!  Perfect!" and two
	more will say, "That was the worst thing I've ever seen!"

	I was about to keep going, but I realized I'm rambling.  I
	shouldn't post to PedTalk after driving to Boston and back to
	see the Red Sox.  At least they won.


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