I’m beginning to think we need to stop President Barack Obama from implementing electronic health records. I didn’t always feel this way.
I’m sitting in a meeting with a doctor friend of mine who is now working for a clinic that uses GE Centricity. This man, a D.O. with a master’s degree in medical informatics, is telling horror stories about how an entire state’s health care system is trying to run on an electronic health record that no one can use.
They are using it because they bought it, although the doctor who bought the system said it bankrupted him and forced hin to sell his practice to the hospital. The hospital doesn’t even use Centricity, it uses Cerner. There’s a jerry-rigged interface to make Cerner talk to Centricity. The databases are not shared.
These are the two leading EHR products on the market right now. But NextGen and Allscripts are no better; I’ve evaluated them all, and I know. Before we implement EHRs, there had better be a panel of users (physicians) talking to Obama, rather than a panel of software companies.
This same doctor, and another friend of mine and I started a small non-profit a few years ago to evaluate these systems and help small practices implement them. The other friend is an MIT grad who has been a professor of Medical Informatics. I was their marketing front end. After helping one practice implement a system, we dropped out of the field. We realized that health care IT doesn’t help the doctors as it is now deployed; instead, it kills their productivity and hurts them. When they don’t adopt it, we criticize them, but THEY ARE RIGHT!!!
A few big products control the movement for CCHIT certification, which keeps smaller, perhaps more useful products out of the market. To get your product certified by CCHIT costs a $30,000 application fee, and then a couple of hundred grand more to go through the process.
This doctor has written his own EHR, so he knows how they work. He gave up marketing it because he was such a small fish in a big pond.
He says GE doesn’t want you to be able to do anything, so they can service the doctors who buy the system. He says GE’s database is sloppy to the point of of absurdity. GE acquired the database from another company, and rather than fix it, they just layered things on top of it. Key fields are named differently even though the data is supposed to relate to each other. And the rich text markup is stored with the data. It’s unreadable.
It’s this doctor’s opinion that no one understands this product. GE’s documentation is also difficult to use. These are expensive, IT-controlled products that are productivity and efficiency killers. You can’t even see the data in the software the way that you want.
Before we force the doctors to make health care worse with these existing products, let’s examine what we are doing. From a usability perspective, the software just isn’t there.