Several years ago, a physician friend, a technologist and I started a small non-profit to help medical practices convert to EMRs (electronic medical records). The physician on our team had written his own EMR, and although we didn’t sell it, we had the benefit of his knowledge of all the existing products. Which suck.
No wonder the providers are freaked out about Obama’s stimulus package and its potential mandate for conversion. Although some of the interfaces are beginning to be re-written in .Net, and one or two of them are web-based, nothing’s really what the doctor’s office needs. The larger practices have ridiculously expensive and difficult to use products like GE Centricity that require extensive training. Google Health has tried it from the other end, trying to empower the user to keep his own online record, but that’s just beginning, and doesn’t tie into the doctor’s record (yet) although I have great faith in Google. Microsoft is also in the hunt.
But most medical practices are small, and very busy and very pinched for resources, both human and financial. The practices we assisted had difficulty making decisions (who gets a PDA, what are the permissions for access, how do we comply with HIPAA, how do we connect with the hospital) and then were daunted by the implementation.
The implementation involves moving mountains of medical records. I was the widow of a radiologist and he rented an entire extra room for his records. But think of this: you are a primary care doctor, and you need records that consist of lab tests, X-rays, faxes, scans — all kinds of media. And ideally, they should be indexable and searchable. There are good workarounds for this, but they’re not perfect yet. I haven’t studied products for a year or so, but things are still burdened also by the legacy systems in large hospitals and medical practices that don’t interface with each other.
So here are my suggestions for Obama:
1. Specify a short list of providers, all of whose products easily interface with one another.
2. Subsidize the practice for implementation costs.