Is the integration of urgent, emergent, inpatient and
care of patients with
acute medical conditions.
Today we announce the third most popular blog of 2012. We congratulate Jason Ruben, MD.
Steve Jobs knew that the key to Apple’s success was simplicity.
Apple products are painstakingly designed for simplicity. Updated Apple products are always better than their predecessor. If you question this, visit an Apple store at the release of the next iPhone or iPad.
Quite the opposite is true in the EMR-healthcare arena. The result: hospital executives are pressured to buy systems that “fit” into their existing IT platform regardless of physician usability. My intention is not to pile-onto the existing discussions about the 15-30% drop in productivity when EMRs are implemented. Unfortunately, I can attest to those numbers within our own organization (thus, the development of the scribe program).
The merits of the HITECH Act, the EHR Federal Mandate, and The Stimulus Package have been greatly discussed. I could argue that EMRs do not provide better patient care.
I want to know who will save physicians, hospitals and patients from the existing, pathetic breed of EMRs available today?
If the deep pockets of Google failed—What’s next?
Who will be the Steve Jobs of the electronic medical record era? Will Allscripts, Cerner or Epic really revolutionize the healthcare industry?
I doubt it.
We need an innovator who can develop a disruptive technology in EMRs that:
1. Is usable —like the iPod.
2. Is universally portable and intuitive from one setting to the next—like the iPad.
3. Is reliable, well designed and not cost prohibitive to implement—like the operating systems on Mac computers.
This innovator will, by default, play a pivotal role in saving our country’s healthcare industry and bend the cost curve in the correct direction.
Yes, it will take more than the perfect EMR system to rescue our healthcare system but I’m optimistic. Dr. Atul Gawande states, “Where people in medicine combine their talents and efforts to design organized service to patients, extraordinary change can result.”
But until this occurs, EMRs won’t decrease healthcare costs. Costs will simply shift.
One study suggests physicians are ordering more tests because of EMR implementation.
We are in the midst of a growth spurt of, as Jobs would say: “crappy” and poorly thought out products.
In the current geopolitical atmosphere, software vendors feel compelled to rush their products to the market space—regardless of how poorly designed they might be. With healthcare reform and the EHR Federal Mandate deadline looming in the near future—they’d be crazy not to. But at whose expense?
Google-health failed because they didn’t apply their resources in the right place.
As Jobs said, "You‘ve got to start with the customer experience and work back toward the technology - not the other way around."
PLEASE, software vendors, think of physicians as your customer. Applying this philosophy, Jobs created the most valuable company in the world.
Will your EMR system revolutionize healthcare the way Apple revolutionized the PC and music industry? If not, chances are I’ll have job security as scribe program director for quite some time.
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Quite the opposite is true in the EMR-healthcare arena. The result: hospital executives are pressured to buy systems that “fit” into their existing IT platform regardless of physician usability.
We need an innovator who can develop a disruptive technology in EMRs that..
We can't trust the software vendor's --their data will always be biased in order to sell more product.
Translation programs to convert between products and provider groups should streamline care in less that ten years.
want to know who will save physicians, hospitals and patients from the existing, pathetic breed of EMRs available today..
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Their exact configuration varies from country to country. In some countries and jurisdictions, health care planning is distributed among market participants, whereas in others planning is made more centrally among governments or other coordinating bodies. Thanks. Regards,
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I hope Sam identifies a translation tool he/she is familiar with, but an implementation I worked on used Altova UModel to translate our custom XML schema to well-formed HL7. That seems like a great solution to interoperability to me.
Can you provide more detail on a "Translation" program? Perhaps add a link to a webpage demonstrating an example of this type of program.
As many products exist and competition weeds out those which are cumbersome innovation and improvement will yield a functional, intuitive version that works for a number of organizations and user groups ranging from MD's, Pharmacists, to RN's, and Therapists. Familiarity should increase as it has with texting and the capital involved will rapidly accelerate the advancement of efficient systems. Translation programs to convert between products and provider groups should streamline care in less that ten years.
CEP has the resources to pay a programer to design one for them. We should make our own, designed with our needs in mind.
There's at least one free, web-based EHR system banking on the value of physicians' time and attention - they offer a version of their EHR for free, guarantee meaningful use, and in exchange they have targeted ads to physicians (I don't know if they'll monetize the data somehow, too, I know I would try). But physician productivity in terms of patients/hour can absolutely be quantified, and in my experience there is a significant drop in patients per hour when an EMR is launched. These costs wouldn't even be the whole story, though, because sometimes there are additional costs on the back end - it can be even harder to get information OUT than it is to get it IN some of these systems.
I concur. If the loss of productivity could be quantified through more research, I believe hospitals would start to see a physician's point of view with respect to patient care and patient satisfaction. But who is doing this research? We can't trust the software vendor's --their data will always be biased in order to sell more product. As for creating the "perfect" product--It doesn't have to be perfect--just USABLE! Jobs's first Mac isn't what we use today. My MacBook Pro will continue to be improved upon and I look forward to buying the next model. During Jobs’s lifetime he had the gift to understand what people wanted better than they knew themselves. I hope the same the occurs with EMR software. Give me something USABLE and I'll patiently wait for the next version. This would be one tiny step towards the perfect EMR.
Good post and interesting comments! Another factor to consider is this: it took Jobs a life time to create the perfect product, and he had to be REALLY mean to get things done right; while the software vendors must sell to survive and their timeline is dictated by government rules and regulations. As far as reducing healthcare cost is concerned, I agree with you that technology is not the answer. healthcare cost has skyrocketed in the past 2 decades, and it was certainly NOT because doctors went back to stone age tools!
Well I hope the EHR designers are listening! The problem is that while physicians should be the "customer" as well as the hospital, the physicians are not paying the "bills" to purchase such software and so have less influence over the selection. The true cost to physicians is in lost productivity,less time with patients, and more time switching between programs for medical records, radiology software for imaging, more programs for lab results, other programs for discharge instructions,etc. The innovator you are asking for will be the one that can make all the programs work with each other, as well as "anticipate" the healthcare provider's next step of the evaluation, treatment, and discharge follow up process.
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