How 5 spine surgeons view IT's usefulness

Practice Management

Five spine surgeons discuss the affect of IT tools on their practice.

Ask Spine Surgeons is a weekly series of questions posed to spine surgeons around the country about clinical, business and policy issues affecting spine care. We invite all spine surgeon and specialist responses.

Next week's question: What are some of the common missteps spine surgeons make early in their career, and how can they be avoided?

Please send responses to Anuja Vaidya at by Wednesday, Sept. 19, at 5 p.m. CST.

Question: How have health IT tools, such as EHRs, affected your workflow?

Noam Stadlan, MD. Neurosurgeon at NorthShore University HealthSystem's Neurological Institute (Glenview, Ill.): IT tools have been extremely beneficial in a number of ways. EMRs allow instant portable access not only to my own notes but also notes from providers in the entire system. Similarly, online imaging (PACS) allows me to review patient images anywhere. This is especially useful when rapid decisions need to be made regarding emergency patients when I am on call. The system also allows easy and rapid communication between providers — usually physicians, but can also be physical therapists, nurses, or other team members — with everyone having access to all the relevant information.

In addition, there is easy and rapid email communication between the patients and our outpatient nursing team which allows us to answer patient questions and concerns promptly. Patients can even send images of their wound or other areas of concern, thus frequently eliminating office visits or allowing rapid institution of treatment.

The EMR also allows easy access to records for record review studies, which streamlines research and allows for identification of disease trends or even geographical modeling. During the winter, our system publishes maps illustrating areas of concentration of colds or strep throat. These capabilities will be employed with greater frequency and with greater effect in the future and will allow us to provide an even higher quality of care.

Rob D. Dickerman, DO, PhD. Director of Neurosurgery at Presbyterian Hospital of Plano (Texas) and Director of Spine Surgery at Medical Center Frisco (Texas): I feel it has slowed my practice down and inhibited my continuity with patient care.

Brian R. Gantwerker, MD. Founder of the Craniospinal Center of Los Angeles: IT tools have left much to be desired. I have gone through many iterations in terms of tools and software that looked and sounded attractive at the time and proved to be less than advertised. What has been absolutely game changing is having an eFax line, robust lines of communication via secure instant message with me and my office and using reliable computer hardware and software that does not need replacing every three years.

Payam Farjoodi, MD. Orthopedic Spine Surgeon at Spine Health Center at MemorialCare Orange Coast Medical Center (Fountain Valley, Calif.): As with the adoption of any new technology, there has been a learning curve to becoming efficient. Over the last several years, we have improved workflow, and I feel that as an office, the overall process now saves some time compared with paper charts. The physician side is a bit more cumbersome than dictating, but my staff does not need to pull charts, organize charts, etc.

In retrospect, the adoption of medical records was a burdensome hoop to jump through without as much benefit as hoped for. One of the best aspects of EMRs — the ubiquitous access to patient information amongst different providers — has been lost in its application.

Richard Kube, MD. Founder and CEO of Prairie Spine & Pain Institute (Peoria, Ill.): The biggest change is the patient interaction and administrative time. There is [now] some screen time that used to be looking directly at the patient and communicating directly. There is also labor involved, especially when using the large systems at the hospitals. Sad given that there has not been any demonstrable improvement in the delivery of care to the patients. Frankly, they are just large systems designed to ensure all codes are captured so that billing is optimized. There is time spent making sure the correct box was checked which translates into less available time for patients.



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