Showing posts with label EMR software. Show all posts
Showing posts with label EMR software. Show all posts

Monday, June 29, 2009

How Doctors feel about EMR vendors too much of the time...

I tried to post a specific Dilbert comic from last week, but the app seems to automatically move to the current cartoon. Fortunately, I think the text is all one needs...
Pointy-haired Boss: We can only afford to fix the high priority bugs
Dilbert: If we don’t fix 100% of the bugs, the software will be 100% useless
Dilbert: So our plan is to fail?
Pointy-haired Boss: More slowly.

Yep - I can't imagine any other executive in any other business putting up with the software physicians are expected to use: clunky, non-intuitive design backed by slow and error-prone technology. Would a bank VP be satisfied with software that required them to use 25 clicks and scrolls to find and document a single transaction? Would an air traffic controller settle for a system that only allowed them to view 1 airplane at a time and which "blew up" 3 times a day?

So why are we having such problems? Likely a combination of:
1. Not getting input from "true" users (do we think the people who created air traffic control software just designed it in-house and then sold it "as is"?).
2. A poorly aligned reimbursement system which provides minimal reason for doctors to use these systems. The potential meaningful use bonus, we be a start - but we still need a more comprehensive reimbursement adjustment to reward efficiency and quality.
3. Lack of standards: I hate to say it, but we are part of our own problem - every time we allow multiple EMR vendors on the same campus or over-customize the software we buy, we make it harder for there to be consistency over time. I think we really need to look at models where there is some consistent framework across the nation, and then there is the ability to add on feature/apps as an option- the "iPhone" model. Examples might include ATM machines, law databases, and again- the air traffic control software (but I'm not sure- feel free to enlighten me).

Finally, there was a recent article which suggested the real problem with EMR adoption is that medical providers are worried that EMRs will "reveal" too many financial secrets- wow, that guy was out of touch. Most docs would love a good system - but it has to be really helfpul to their daily lives. How would that writer like it if his Word processing software required him to click on 5 things to get a capital letter, and 6 to start a new paragraph? And what if he could get paid more for handwriting his columns because it was faster for him?