Blogger John at the “EMR (EHR) and HIPAA” blog posted a musing that caused my business antennas to twitch. A vigorous discussion has started in the comments.
Here’s the thing: we’re talking about the billions of incentives we’re offering providers to adopt EMR systems, and still many docs aren’t interested, or have had horrible experiences because (according to many accounts) the systems are hard to use or simply not worth the effort.
Now, I know from business, if you offer something your intended users don’t like, guess what happens? Flopzilla.
(I say this strictly from a business perspective; I have never seen, much less touched, an EMR system.)
So here’s the question for doctors considering whether to get an EMR system:
If it were FREE would you take it?
If the answer is no, then I have a front-page WSJ prediction about how effective the stimulus incentives will be.
Please go read the comments over there.
I think I can see the front page article already. The problem is that there are about 400 different EHR companies. Unfortunately, the EMR stimulus will end up going to support those EMR that are the least usable (in most cases). This will lead to widespread dislike of EMR systems.
The byline for the story will be “Big EHR Vendors Get Rich Off of EMR Stimulus Money”
Thanks for the link and comment. I’ll have to do my own post on “If it were FREE would you take it?”
Well John, presume you’re the guy who runs the EMR Wiki, I can’t think of a better person to host an opinion poll by docs from around the world about usability, usefulness, and value, about any number of contenders.
Speaking just for myself, again, I want the world (providers & patients alike) to receive the benefits I KNOW are possible from good valuable automation. I don’t want that objective clouded by crummy systems that give the movement a bad reputation.
Want to collaboratively host and/or promote such a survey?
(In case you’re wondering, I have no idea what I’m getting myself into, but I believe it’s a good idea, and as much as I like providers who listen to what patients want, I equally like it when patients listen to what providers want!)
Sounds like an interesting project. I am the guy who runs the EMR wiki. It still has a long way to go, but I see it as a marathon and not as a sprint. I’m in this for the long haul.
I’d be interested to know what type of survey you’re talking about. This is especially interesting since I’m probably going to start a PhD in healthcare informatics this fall (assuming the program is still around with all these budget cuts). I definitely want to do what I can to improve the situation. I think education is key.
I find the debate around EHRs and such in the USA a little bemusing sometimes. I’ve been to a lot of doctors here in Australia since 2003 and only one still used paper records, and they were a very conservative specialist. The hospitals still use paper records on admission to the ER (along with a general computer entry) but this is because they don’t have wireless tablets to match yet, I presume. The pathology and imaging labs all link up to the doctors with EMRs and send them results this way. The next step is making it a truly IEHR (integrated EHR) with communication between all hospitals, clinics, labs and practices – and the patients. There’s a national strategy for e-health available here:
http://www.health.gov.au/internet/main/publishing.nsf/Content/eHealth and the Authority in charge of it is http://www.nehta.gov.au/
I’ve read through most of it, and it seems to be heading in a sort-of-OK direction. There’s a quote on the NEHTA:
This is not really consistent with collaborative medicine and e-patients – the EHR is being set up to be primarily of benefit for the doctor, no mention of patient-doctor interaction, etc. It seems they’ve missed the boat on that, and I’m keeping my eye out for any parliamentary committees or calls for public comment on this program so I can put in submissions.
what’s the WSJ prediction? please provide a link?
Having worked with the NIH through their caBIG initiatives, I can say that the best solution here will not NOT NOT be to come up with software. It seems that most of the solutions out there involve picking/building a piece of software. This is problematic for many reasons: Care providers may already have a system that works, they may find that the “solution” proposed by the government doesn’t fully meet their needs, it may be too expensive to buy/implement/support, etc etc etc
In general everyone’s needs are best served when there is a STANDARD devised that different systems can conform to. That way people can use whichever actual SYSTEM they choose, so long as that system can communicate with everything else in some standard way.
The downside to this is that standards are MUCH harder to create and implement than systems, but I think it’s a better approach than simply foisting some software on everyone…