Re: Walmart Health: Just had a great dental visit this morning, which was preceded by helpful reminders from Epic, and…
Intelligent Healthcare Information Integration 1/19/11
Home Runs & Hat Tricks vs. Game Winners & Buzzer Beaters
Jordan fades back, it’s up…it’s GOOD!!!
Who doesn’t love a good, last-second, game-winning, buzzer-beating score – in sports, literally, or at work, in a more figurative sense? We all want to be the one who nails an amazing game changer or at least be a part of the team that does.
On the EMR/EHR hunt these days, I’ve seen some pretty impressive home runs and even a few hat tricks. But, there’s a big difference between home runs and hat tricks compared with game winners and buzzer beaters.
In fact, many of the EMRs and EHRs I’ve looked at lately have hit a homer or two, maybe even completed a solid hat trick. But hat tricks and home runs are a far cry from game-winning grand slams. Many — maybe even most — vendors have found some really cool ways of getting certain tasks or job functions digitally handled. But, that is where the problem begins.
I’d wager that pretty much every EHR out there started off with at least one or two unique ideas, genuinely cool features or functions that hadn’t been created elsewhere. But since there is a lack of standardization, each of these cool tools must then have a full EHR built out around it. Unfortunately, the cleverness doesn’t seem to pervade the rest of the build out – almost never.
Thus, as the EHR hunt continues to show, really great ideas are often trapped within an overall dull total package. Slick data capture gets caught up with a horrendous user interface. Cool communication functionality gets mired in a mountain of clicks and drop-downs. Stylish user experiences get hamstrung by a lack of good templates or content. Fancy evidence-based tools lose value from dull-witted programming that causes unacceptably slow workflow.
Imagine if none of our electronic gadgets had a standardized plug or wall outlet design. All the best electronics in the world mean nothing if you can’t get power connected to enable their meaningful use.
Here’s a great example of a very cool tool I just learned about that would benefit from more intersystem connectability: Doctrelo eRx Plus. OK, this link doesn’t really give you deep insight into the product; it’s actually still in alpha. But, trust me: Doctrelo’s eRx Plus e-prescribing system, based on clinical problems and designed around how providers actually think, is the slickest e-prescribing tool I’ve ever seen.
Just like having a standard shape for electrical outlets and plugs, having such standardized EMR component “work-togetherness” would sure go a long way in bringing about real, cream-of-the-crop, game-winning EHRs. Goodness knows I’ve seen some really phenomenal parts and pieces recently. I continue to think, “What a great system I could create if I could take one from vendor A, two from vendor B, etc.!”
But then, as anyone who’s tried to charge their phone in Kathmandu or Kuala Lumpur will attest, we can’t even get electrical outlets or voltages standardized. I’m probably hoping for too much from my next EHR. Maybe just a good hat trick will have to hold me for now.
From the trenches…
“You have to expect things of yourself before you can do them.” – Michael Jordan
Dr. Gregg Alexander, a grunt in the trenches pediatrician, directs the “Pediatric Office of the Future” exhibit for the American Academy of Pediatrics and is a member of the Professional Advisory Council for ModernMedicine.com. More of his blather…er, writings…can be found at his blog, practice web site or directly from firstname.lastname@example.org.
Gregg, thanks for the kind words about the Doctrelo eRx+ e-prescribing “plus” system. Its development has been a labor of love. I agree that it would be wonderful if there were realistic ways that clinical software developers like Doctrelo could build innovative, commercially viable products without being forced to reinvent the entire wheel. I welcome and applaud any serious efforts towards interoperative EHR modularity.
I’ve been advocating for something similar to this for years. Here’s a paper I published in 2005: http://www.himss.org/asp/ExternalLinksRedirector.asp?ContentID=65445&ExternalURL=%2E%2%2Fcontent%2Ffiles%2Fjhim%2F19%2D4%2FEnvironmentsforInnovation%2Epdf. Granted, the spin was a bit different as was the setting (i.e., inpatient vs. outpatient), but the general principle of “doing innovative stuff without having to reinvent the wheel” still holds.
Oh wait, that link didn’t seem to work. Try this one: http://bit.ly/h8psHF
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