A fresh start…


I don’t know about you, but I for one am sick and tired of the defeatist approach to the concept of multiple EMR vendors in this province.   Sometimes it seems that the parade of excuses goes on forever.

We can do without the negative thinking.  Pessimists and nay-sayers need to stop obstructing progress and make way for others with vision and a “can do” attitude.

There are those who believe EMR vendor’s just can’t make it in this province unless they sign up 500 clients and have a secret contract to hobble the competition.  These same people note that there are fifteen vendors currently supplying doctors in this province.    Even though these vendors only have a handful of clients, they seem to be doing just fine, despite being undermined by the Data Sharing Agreement.   Velante’s claim that their product can only survive by cutting the legs out from under the competition speaks volumes to the weakness of their business plan.

A well planned business should stand on it’s own two legs, and not need to be propped up by government handouts and secret deals which foul the waters for competitors.

Play fair or get off the field.

Nobody wanted the Velante system to fail, but fail it has.

The Minister of Health says the province may step in to bail out the sinking Velante vessel.  Ironically, that may result in another plan just as expensive and centralized as the current one which will compel doctors to use a “one size fits all” EMR.   That’s a scenario which is to be avoided.

Here is my plan:  It’s cost effective, provides for freedom of choice for doctors, and will improve health care outcomes.

  • Admit the Velante plan has failed.   Let’s cut our losses and disband or remodel the company.  Cut Accreon out of it.   Intrahealth should be able to continue to provide support to the 34 doctors currently using their software.
  • Tear up the Data Sharing Agreement.
  • Allow any vendor who is prepared to pay the cost of interconnecting with DOH computers to do so.   Any vendor who cannot pay the cost can still function under current conditions, just as they have been all along.
  • Establish a system of “Sentinals.”   By this I mean a group of doctors selected from all parts of New Brunswick, who are advanced EMR users, each with practices of over 2000 patients, who are making full use of their EMR’s including the use of standard ICD-9 disease coding.
  •  Employ a provincial Health Statistician whose job it will be to collect data from the Sentinel physicians in order to provide statistics on disease prevalence and control, medication use, immunization rates, and utilization of health care resources – all on a quarterly basis.   With even a dozen doctors participating, you will have a sample of 24,000 or more, which should be adequate to provide reliable figures for the province to use.
  • Sentinal physicians would receive a monthly stipend to compensate them for the additional time and effort required to keep their records in a state which permits easy data mining.

This plan would accomplish several important goals:

  • Physicians would be free to choose the EMR which best suits their needs, or continue to use a paper based system.   Over the next 10 or 20 years, the proportion of doctors using EMRs is going to grow with out any help, as new doctors don’t want paper charts, and are part of a more tech-savvy generation.
  • Physicians could choose an EMR which interconnects with DOH databases if they wish, or a simpler system – which is likely to be the choice of many specialists – with more limited capabilities.
  •  Physicians who do not interconnect can still access the provincial EHR, as they can now, using the existing portal.
  • The Department of Health would benefit from access to data from a representative sample of the population, which if designed properly by a competent statistician, would give very accurate and usable information.
  • Early adopters could take on the role they should have had all along, as the greatest supporters and promoters of EMR technology.
  • The I.T. industry would receive a boost by having the opportunity to write software packages which could perform functions such as data migration, for patients who move from another province and are able to bring their electronic medical file with them.   We will need people to develop apps and provide security and data encryption programs for tablets and laptops, maybe even smartphones.
  • The only downside to this plan is that Accreon would lose one of its cash cows.   Even this might not be much of a loss, as that cow is currently producing sour milk, and not much of it.

This system, implemented properly would realize tremendous savings to the province while still providing the data the department needs.   Doctor buy-in and satisfaction would rocket upward.   The I.T. sector for small local players would get a huge boost.

The time has come for NB EMR 2.0.

Are you in, or out?


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