In 2008, completely free text documentation is the 5x7 cards of 1984

In contrast to free text, SMARText offers far greater potential because it makes it possible to detect and report quality improvement measures more directly. The leap from free text to SMARText demands a slight shift in focus from pure productivity alone (productivity based solely on current, dysfunctional reimbursement models).

In 2008, the completely free text style of SOAPware v4 is the 5x7 cards of 1984!

The analogy… My senior partner in my first practice never relinquished his resentment about having to switch to paper charts in 1984. I will never forget the episode when he angrily complained that he now had to perform no less than 100 chart opening-closings daily. This decreased his productivity, and he never saw the real need for anything more than the 5x7 paper cards. In fact, he still felt that way after experiencing severe consequences resulting from failed chart reviews. This contributed to his needing to retire prior to his intent.

SOAPware 2008, at is very core, is designed to promote the highest quality with the least effort. This requires technologies offering for any/all tasks to be performed with either free text or structured data. It facilitates a gradual migration taking clinicians where they are today and transitions them to more quality data instead of only having the free text gobbilty-goop of today’s medical records.

The practices that thrive will actively adapt their work flows and use technology to work smarter instead of harder. They are not focused on just short-term economic productivity, but on high quality productivity

Don't shoot the messenger here, but the days of fee schedule increases, across the board are limited, if not dead altogether. Certainly, there is not a chance that fee inctreases will keep up with inflation. Any significant fee increases to come will, in some fashion, be tied to what will be referred to as "performance measures." In actuality, in the short term, it will be fee increases for some type of reporting of data beyond ICD/Diagnosis codes and CPT/Procedure codes.

Interestingly, new EMR users tend to understand this better than those who are using SOAPware v4. New users have typically looked at how cumbersome it is to collect quality measures in most MR systems. They are amazed how much easier it is to enter structured data in SOAPware 2008. SOAPware 2008 is designed, at its core, to do that in the easiest, possible fashion. The free text in v4 and other simple, text-based EMR's will require many extra steps and additional charting before the data can be collected.... not a lot better than a 5X7 paper card, unfortunately.

Randall Oates, M.D.