Comments on: MD Leader 1/27/09 http://histalk2.com/2009/01/26/md-leader-12709/ Healthcare IT News and Opinion Thu, 09 Feb 2012 01:56:16 +0000 hourly 1 http://wordpress.org/?v=3.3 By: Martin Coyne http://histalk2.com/2009/01/26/md-leader-12709/comment-page-1/#comment-3253 Martin Coyne Tue, 03 Feb 2009 16:17:37 +0000 http://histalk2.com/2009/01/26/md-leader-12709/#comment-3253 I totally agree. And I totally disagree. First, I do agree with the point that a tool does not by itself make things better. That tool must become part of a bigger workflow and process to leverage its capabilities. Many, it seems, think that procuring (or developing) a solution will fix everything. If leadership doesn't drive process improvements - it won't. Now, at this point in time, even the big boys like Microsoft are struggling to keep up in sw development despite having deep pockets and tons of very talented resources. Can a user really develop a best in class solution. Let's pretend they have the skills. I cannot imagine they don't have a better use of their internal resources. Lots of issues here. Willingness to change the process? SaaS? Customization? Local Integrators? Cost and funding source? Who derives the value? All possible reasons for low EMR adoption rates. I totally agree. And I totally disagree. First, I do agree with the point that a tool does not by itself make things better. That tool must become part of a bigger workflow and process to leverage its capabilities. Many, it seems, think that procuring (or developing) a solution will fix everything. If leadership doesn’t drive process improvements – it won’t.
Now, at this point in time, even the big boys like Microsoft are struggling to keep up in sw development despite having deep pockets and tons of very talented resources. Can a user really develop a best in class solution. Let’s pretend they have the skills. I cannot imagine they don’t have a better use of their internal resources.
Lots of issues here. Willingness to change the process? SaaS? Customization? Local Integrators? Cost and funding source? Who derives the value? All possible reasons for low EMR adoption rates.

]]> By: Art_Vandelay http://histalk2.com/2009/01/26/md-leader-12709/comment-page-1/#comment-3204 Art_Vandelay Thu, 29 Jan 2009 01:14:03 +0000 http://histalk2.com/2009/01/26/md-leader-12709/#comment-3204 If what some physicians want was in existence, a number of those who have built their solution likely would not have made that choice. If what some physicians want was in existence, a number of those who have built their solution likely would not have made that choice.

]]> By: Will Weider http://histalk2.com/2009/01/26/md-leader-12709/comment-page-1/#comment-3198 Will Weider Wed, 28 Jan 2009 20:53:25 +0000 http://histalk2.com/2009/01/26/md-leader-12709/#comment-3198 I don't think Pete is advocating internal development. He is stating that we did not think that would be where we ended. We need to guard against these pre-conceived notions. We miss a lot of opportunities because of cliches that we rattle off as if they were laws of physics....you never get fired for buying IBM...Integrated solutions are always better than best of breed...there is no room for open source in the enterprise...most of our patients wouldn't go online...blah, blah, blah. I don’t think Pete is advocating internal development. He is stating that we did not think that would be where we ended. We need to guard against these pre-conceived notions. We miss a lot of opportunities because of cliches that we rattle off as if they were laws of physics….you never get fired for buying IBM…Integrated solutions are always better than best of breed…there is no room for open source in the enterprise…most of our patients wouldn’t go online…blah, blah, blah.

]]> By: Will Weider http://histalk2.com/2009/01/26/md-leader-12709/comment-page-1/#comment-3197 Will Weider Wed, 28 Jan 2009 20:43:29 +0000 http://histalk2.com/2009/01/26/md-leader-12709/#comment-3197 Dr. Sanderson's point was the EHR alone cannot achieve the desired results. There needs to be a lot of work around leveraging the technology. Do people disagree with that? Are people unaware of the numerous spectacular failures in healthcare IT? Dr. Sanderson’s point was the EHR alone cannot achieve the desired results. There needs to be a lot of work around leveraging the technology. Do people disagree with that? Are people unaware of the numerous spectacular failures in healthcare IT?

]]> By: Evan Steele, CEO, SRSsoft http://histalk2.com/2009/01/26/md-leader-12709/comment-page-1/#comment-3173 Evan Steele, CEO, SRSsoft Tue, 27 Jan 2009 22:23:44 +0000 http://histalk2.com/2009/01/26/md-leader-12709/#comment-3173 Dr. Sanderson drives the case for being both the developer and vendor of an EMR product, as well as the user. Is this a practical way to go? I'm sure the substantial resources consumed in developing, testing and quality assuring the product have focused on his clinic's preferences. As all of us who have spent a lifetime providing services and products to the medical community know, each practice is unique in its way of doing business, right down to templates and workflows. EMR's by their nature have to be flexible and adaptable to accommodate this; but that configurability is what makes them more difficult to use "out of the box." There are tradeoffs at every turn--easy to configure or more rigid in design? Either way, practices must change the way the doctor-patient encounter has traditionally taken place. With traditional EMR's, that often means putting a technology device between the patient and the doctor, ergo the slowdown and loss of productivity that has so marred the EMR experience up to this point. In many ways, this explains why EMR adoption continues to be very low. That's why hybrid EMR is rapidly gaining traction, especially in higher volume, multi-doctor practices and clinics. The trade-offs are much easier and do not hamper the patient-doctor encounter or slow it down. Practices should not have to develop their own products. That takes time, capital and resources which are then not available for providing better patient care. If traditional EMR worked like PHYSICIANS wanted them to, there would be no need for what Dr. Sanderson has tried to do. We need our physicians to keep spending quality time with us and giving us great care. Hopefully tools like hybrid EMR will allow them to do that without having to spend so much on building their own tools. Dr. Sanderson drives the case for being both the developer and vendor of an EMR product, as well as the user. Is this a practical way to go? I’m sure the substantial resources consumed in developing, testing and quality assuring the product have focused on his clinic’s preferences. As all of us who have spent a lifetime providing services and products to the medical community know, each practice is unique in its way of doing business, right down to templates and workflows. EMR’s by their nature have to be flexible and adaptable to accommodate this; but that configurability is what makes them more difficult to use “out of the box.” There are tradeoffs at every turn–easy to configure or more rigid in design? Either way, practices must change the way the doctor-patient encounter has traditionally taken place.

With traditional EMR’s, that often means putting a technology device between the patient and the doctor, ergo the slowdown and loss of productivity that has so marred the EMR experience up to this point. In many ways, this explains why EMR adoption continues to be very low. That’s why hybrid EMR is rapidly gaining traction, especially in higher volume, multi-doctor practices and clinics. The trade-offs are much easier and do not hamper the patient-doctor encounter or slow it down.

Practices should not have to develop their own products. That takes time, capital and resources which are then not available for providing better patient care. If traditional EMR worked like PHYSICIANS wanted them to, there would be no need for what Dr. Sanderson has tried to do. We need our physicians to keep spending quality time with us and giving us great care. Hopefully tools like hybrid EMR will allow them to do that without having to spend so much on building their own tools.

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