The HISTalk Blog lets users write in with ideas, rants, and raves now and then - and a recent post by an anonymous writer was so good - I am reposting it here. He wrote up a ten point program to improve EHRs... it was great. I think the first four points are key for actual development, the others are important for deployment. Read on:
10 Point Program to Improve EHR software
1.Less configurable. The Demotivators® said it best “When people are free to do as they please, they usually imitate each other”. Every hospital or physician practice is unique — they uniquely solve the exact same problems everyone else is facing.
2.Better designed. End-user input and UI design should be part of the specs, not the pilot.
3.Customer-prioritized enhancements. Fifty percent vendor-driven (sales and demo feedback, regulatory requirements, infrastructure, etc.), 50% prioritized by customers. Yearly process, projects grouped to be equal number of hours, one vote per licensed bed, top x projects will be roadmapped to fill 50% time.
4.Consensus-driven standard content and configuration. Vendor designed, large group customer editing — majority rules, everyone uses.
5.Remote hosted. 99.999% uptime, capacity and response time are key requirements.
6.Rapid install. If you’ve followed 1-5, training the end-users should be the most time-intensive phase of the implementation.
7.Qualified buyers. We’ll sell to you if you agree to: follow our standard workflows, use our standard build and participate (end-user input, content design, and prioritization). Must agree to mandate adoption! Better to support 50 involved, committed customers than 100 unhappy, non-standard, partially-implemented, low-adoption targets.
8.Equitable pricing. Low upfront, subscription-based. Every customer pays the same, scaled by size or volume.
9.Play nice with other vendors. Integration > Interfacing > Interoperating.
10.Record portability. Remove vendor lock-in. The intersection of the NHIN and CCDs with the market transitioning to replacement will make this a necessity. You know it will be mandated eventually.
The only thing I'd add is the concept of "Open those platforms" - meaning the vendors should release APIs that allow 3rd parties to innovate on the user interfaces and functionality that can interact with the data model without changing it (as per some past posts).