Forcing a fit…

Making it Work

Making it work takes a little longer.  Making it work takes a little time. –  Doug Bennett

The EMR experience in the United Kingdom should not be ignored.   Painful lessons have been learned about putting all your eggs in one basket with a single monolithic electronic record system.   In the article linked below,  some of the analysis refers to the hospital-based EHR rather than the office-based EMR which is the focus of this blog, but the findings can easily be extrapolated.

New Brunswick is plunging headlong to the same disastrous muddle that has befallen our British cousins.   It bears thinking about.

We don’t all work the same and even within medical specialties there are differences in how people use computers and what software suits their eye.   Choice is THE key element in physician satisfaction with EMRs.   Forcing a fit is never a good idea.

“There are huge differences between a surgical specialty practice, primary care and hospital systems. The result of a one-size-fits all mentality in healthcare is a lowest common denominator approach to building solutions which has led to generic, yet shockingly expensive, products that are not well liked or used.”  – Daniel Cane, CEO of Modernizing Medicine

Anyone listening?   Is that a path we want to go down?

I think not.

It’s time for doctors to decide what they want in an EMR.    Time to stop the tail from wagging the dog.   I.T. professionals are key players in developing more fully functional electronic medical record systems, but we should be telling them what we need.  Physicians need to lead, not follow.  Software vendors need to find out what works for us, then make it happen.   And if they can’t do it, we should find someone who can.   That’s the beauty of a free and open marketplace.   It fosters innovation and healthy competition.

A good first step would be ending the EMR monopoly in New Brunswick.   It is ludicrous that physicians in this province are being offered only one EMR solution.   No one would tolerate going to a restaurant with only one item on the menu.   Yet that’s the choice offered by Velante, as they attempt shepherd us into their shearing barn.

Fortunately, physicians don’t herd well.

“EHR companies have followed a business model whereby they control all data, rather than liberating the data for use in innovative applications in clinical care.” –  Dr. Farzad Mostashari

Well said.

We need a variety of systems that talk to each other.    It’s not a question of whether it can be done.   It’s a question of will.

As you are about to read, health IT authorities in the United Kingdom have made it quite clear that “interoperability is a key priority …  If there is not sufficient progress or we continue to see barriers that create data silos or ‘walled gardens’ we will… consider other options to achieve our policy intent.”

This is the kind of leadership and vision that is sorely lacking in New Brunswick.  Both our Department of Health and our Medical Society would do well to take a lesson from the British experience with electronic medical records.   There needs to be more emphasis on enabling health care providers, more vision and innovation, and, above all, we need to learn from those who have gone before us.

Enjoy the read.


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