Comments on: Electronic Medical Records… http://www.letstalkhealthcare.org/health-care-costs/electronic-medical-records/ Tue, 06 Jan 2009 22:45:03 +0000 http://wordpress.org/?v=2.5.1 By: Electronic Medical Records Guy http://www.letstalkhealthcare.org/health-care-costs/electronic-medical-records/#comment-2136 Electronic Medical Records Guy Thu, 16 Aug 2007 16:37:38 +0000 http://www.letstalkhealthcare.org/?p=99#comment-2136 I think it's important to evaluate (and then anticipating!) the true cost of an electronic medical record system implementation. Too often, physicians focus only on the upfront costs, and forget that it takes a fair amount of time and resources to maximize their new system. This isn't to say you shouldn't pay attention to upfront costs - some systems require an unreasonable initial investment - but even the cheapest systems will require extra effort upon "go live". Bottom line: Do your homework, make a selection and invest a lot of energy in making your system work well in your office. By far, the single greatest post-purchase investment is your own time and energy. It will take a few months to learn everything about your system. Even the easiest systems require work - unfortunately, all of your problems WILL NOT go away simply by flipping the EMR switch. DON'T GET FRUSTRATED! Stay focused and you'll soon reap all the incredible benefits of an electronic medical record software system. EMR Software Guy, http://www.electronic-medical-record.blogspot.com I think it’s important to evaluate (and then anticipating!) the true cost of an electronic medical record system implementation. Too often, physicians focus only on the upfront costs, and forget that it takes a fair amount of time and resources to maximize their new system.

This isn’t to say you shouldn’t pay attention to upfront costs - some systems require an unreasonable initial investment - but even the cheapest systems will require extra effort upon “go live”.

Bottom line: Do your homework, make a selection and invest a lot of energy in making your system work well in your office. By far, the single greatest post-purchase investment is your own time and energy. It will take a few months to learn everything about your system. Even the easiest systems require work - unfortunately, all of your problems WILL NOT go away simply by flipping the EMR switch. DON’T GET FRUSTRATED! Stay focused and you’ll soon reap all the incredible benefits of an electronic medical record software system.

EMR Software Guy,

http://www.electronic-medical-record.blogspot.com

]]> By: Charlie Baker http://www.letstalkhealthcare.org/health-care-costs/electronic-medical-records/#comment-601 Charlie Baker Sat, 23 Jun 2007 19:08:52 +0000 http://www.letstalkhealthcare.org/?p=99#comment-601 br - Fair enough. The IT guys probably over-promise on their ability to simply digitize existing processes for providing and documenting care in a practice or a hospital. That said, most of us who've been through one of these, and I've been through several, know that one of the benefits of installing a new system is the opportunity check up on - and change - existing ways of doing business to adjust to changes in the way the information can be collected, stored and manipulated. It's sort of like spring cleaning - on a much grander scale - and it's usually a good opportunity to re-think and reconsider our standard way of working. That's not always a bad thing. br - Fair enough. The IT guys probably over-promise on their ability to simply digitize existing processes for providing and documenting care in a practice or a hospital. That said, most of us who’ve been through one of these, and I’ve been through several, know that one of the benefits of installing a new system is the opportunity check up on - and change - existing ways of doing business to adjust to changes in the way the information can be collected, stored and manipulated. It’s sort of like spring cleaning - on a much grander scale - and it’s usually a good opportunity to re-think and reconsider our standard way of working. That’s not always a bad thing.

]]> By: br http://www.letstalkhealthcare.org/health-care-costs/electronic-medical-records/#comment-581 br Fri, 22 Jun 2007 03:25:11 +0000 http://www.letstalkhealthcare.org/?p=99#comment-581 AA; I assume you are a physician office EMR vendor. Don't call it tired and simplistic until you've tried to work one of the darned things while trying to take care of a patient at the same time. And by the way, my comments were directed toward systems in hospitals, which are the only ones with which I have any experience, being a hospital-based physician. I can imagine trying to implement one in an office would be an even bigger nightmare, although on a smaller scale. But you've hit the nail on the head when you say sometimes the vendor falls down on workflow consulting. Keep in mind you are not selling to people who are familiar with how to integrate these things into processes they have used for years. AA;
I assume you are a physician office EMR vendor. Don’t call it tired and simplistic until you’ve tried to work one of the darned things while trying to take care of a patient at the same time. And by the way, my comments were directed toward systems in hospitals, which are the only ones with which I have any experience, being a hospital-based physician. I can imagine trying to implement one in an office would be an even bigger nightmare, although on a smaller scale. But you’ve hit the nail on the head when you say sometimes the vendor falls down on workflow consulting. Keep in mind you are not selling to people who are familiar with how to integrate these things into processes they have used for years.

]]> By: AA http://www.letstalkhealthcare.org/health-care-costs/electronic-medical-records/#comment-576 AA Thu, 21 Jun 2007 17:10:09 +0000 http://www.letstalkhealthcare.org/?p=99#comment-576 Mr. Baker, I submit to you that the only way to measure clinical quality is with clinical data. Capturing clinical data generally requires use of some sort of EMR. Administrative data falls short of providing real high value metrics other than cost data in my opinion and according to available studies. Until EMR technology is prevalent, there will not be accurate clinical quality. br, Blaming the software in a blanket statement is a tired and simplistic argument. The vendors have improved and EMR software has been demonstrated to work well for many practices. There are also clearly many failures (including some rather famous and expensive catastrophes). Yes, a practice must accept that there must be significant change to workflow and optimization to be performed when implementing an EMR. Workflow can be optimized in ways that improve processes when the right team is cross-functional team is assembled. Sometimes vendors fall down on workflow consulting which causes more failures than inadequate technology. Other times physicians refuse training or don't participate in the clinical workflow redesign process. Often it's a combination of these factors. If physicians want successful EMR implementations, they must be very involved in the whole process, willing to change, and play well on a workflow redesign team. This is often more time and effort that physicians are willing to bear. Interoperability will continue to be an issue in large part due to the complexity of medical data. It takes companies to play nice which is a challenge but HITSP (Health Information Technology Standards Panel) and CCHIT (Certification Commission for Health Information Technology) are a good running start towards the goal of interoperability. Mr. Baker,

I submit to you that the only way to measure clinical quality is with clinical data. Capturing clinical data generally requires use of some sort of EMR. Administrative data falls short of providing real high value metrics other than cost data in my opinion and according to available studies. Until EMR technology is prevalent, there will not be accurate clinical quality.

br,

Blaming the software in a blanket statement is a tired and simplistic argument. The vendors have improved and EMR software has been demonstrated to work well for many practices. There are also clearly many failures (including some rather famous and expensive catastrophes). Yes, a practice must accept that there must be significant change to workflow and optimization to be performed when implementing an EMR. Workflow can be optimized in ways that improve processes when the right team is cross-functional team is assembled. Sometimes vendors fall down on workflow consulting which causes more failures than inadequate technology. Other times physicians refuse training or don’t participate in the clinical workflow redesign process. Often it’s a combination of these factors. If physicians want successful EMR implementations, they must be very involved in the whole process, willing to change, and play well on a workflow redesign team. This is often more time and effort that physicians are willing to bear.

Interoperability will continue to be an issue in large part due to the complexity of medical data. It takes companies to play nice which is a challenge but HITSP (Health Information Technology Standards Panel) and CCHIT (Certification Commission for Health Information Technology) are a good running start towards the goal of interoperability.

]]> By: br http://www.letstalkhealthcare.org/health-care-costs/electronic-medical-records/#comment-566 br Tue, 19 Jun 2007 11:39:14 +0000 http://www.letstalkhealthcare.org/?p=99#comment-566 Mr. Baker; I agree with your basic premise that EMR's by themselves will not revolutionize health care. However, I submit that the biggest problem is not the carpenter but the manufacturer of the hammer and therefore the hammer's quality. As a clinician veteran(or perhaps the correct term is victim) of several hospital computer installations, I can tell you the vendors have little idea of what makes a truly functional health care computer system. Although they are advertised as having the ability to "transform clinical work processes", that is just a euphemism for the fact that the work process must conform to how the computer will allow you to perform it - and many are a step backward rather than forward. I agree that the carpenter is limited as yet, in many cases because the providers are led by older leaders who are not as computer-savvy as our kids, and therefore lack the vision of what a good system can do. BUT - they've got to have a good tool to work with first. In addition, it's the vendors who oppose interoperability of different systems more than the hospitals, due to obvious profit motives. We desperately need a Steve Jobs-like visionary in health IT who will transform the industry nationally. Mr. Baker;

I agree with your basic premise that EMR’s by themselves will not revolutionize health care. However, I submit that the biggest problem is not the carpenter but the manufacturer of the hammer and therefore the hammer’s quality. As a clinician veteran(or perhaps the correct term is victim) of several hospital computer installations, I can tell you the vendors have little idea of what makes a truly functional health care computer system. Although they are advertised as having the ability to “transform clinical work processes”, that is just a euphemism for the fact that the work process must conform to how the computer will allow you to perform it - and many are a step backward rather than forward.

I agree that the carpenter is limited as yet, in many cases because the providers are led by older leaders who are not as computer-savvy as our kids, and therefore lack the vision of what a good system can do. BUT - they’ve got to have a good tool to work with first. In addition, it’s the vendors who oppose interoperability of different systems more than the hospitals, due to obvious profit motives.

We desperately need a Steve Jobs-like visionary in health IT who will transform the industry nationally.

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