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Could Amazon or Facebook Build A Better EMR?

Posted on February 18, 2011 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

As we all know, few EMRs are a breeze to use.  In fact, many have such awkward, counterintuitive UIs that they ought to be thrown back into the pond.

On the other hand, superstar consumer apps like Facebook and Amazon have hooked people by the millions with intuitive, logical interface designs that simply addict users.  (And let’s not forget Apple, whose gift for consumer design has vaulted it from has-been to trend setter for the world.)

One CIO, Dale Sanders of the Cayman Island Health Authority, has taken these  examples and run with them, making what seems like a very strong argument in favor of the these giants’ approach:

In Facebook, we have a perfect framework for longitudinal documentation, collaboration, messaging, and scheduling between a patient and members of their entire care team, including family and friends.

We also have a framework for easily integrating data from other sources to enhance the value to the patient’s healthcare – there’s no equivalent of HL7 interchange going on in Facebook.  It references data located in other sources and systems. Can you imagine Facebook surviving if it required itself to house all the data that it presents?  Facebook takes great advantage of referencing and pointing to data in the source systems.

In Amazon, we have a perfect and familiar metaphor for ordering tests and procedures; tracking them; assessing their costs; rating them and seeing how other clinicians rated those orderables and referrals; and adjusting orders based on the behaviors and ratings of other clinicians, etc.

What makes his thoughts more interesting is that he actually marks up screenshots of key Amazon and Facebook pages, commenting directly on aspects he thinks EMR vendors could adopt.  It’s a thought-provoking exercise:  I recommend you check it out.

When will Doctors Enthusiastically Get and Use EMR Software and EMR Systems?

Posted on July 22, 2009 I Written By

One Hundred Percent of Doctors and their offices use Practice Management Systems (PMS). Only 3% user “fully functional” EMR Systems. Why only 3% with EMRs and 100% with PM Systems?

The government is going to pay us $44,000 per doctor to use an EMR. They are going to give us a 2% Medicare bonus and other pay-for-performance incentives and they are going to penalize us in the future if we don’t use EMRs. In addition, hospitals are allowed to pay 85% of the cost of the software and training. Will all this money get us the use EMR? Can we be bought? Is it in our interest to use EMRs?

The CEO of SRSsoft tells us that this type of money is not significant if the EMR makes you less productive and less efficient. For example, if you bill $500,000 per year and your EMR makes you 10% less efficient, you lose $50,000 per year!

I agree with this CEO. We (doctors) will not embrace EMR systems until they are usable and they add value! “Usability is the effectiveness, efficiency, and satisfaction with which the intended users can achieve their tasks in the intended context of product use.” This definition comes from NIST, ISO and UserCentricity. Adding value means that it makes our jobs more enjoyable, shortens our work day or helps us provide better care.

Doctors use practice management systems because they are usable and they add value. Doctors do not use EMR Systems because most DO NOT add value and they are not usable. There are so many bad EMR systems on the market that the stench and confusion has caused many doctors to not even look (they ask their colleagues who have EMRs and these colleagues say “stay away, it is not worth the cost, aggravation and problems”).

I believe that there are some very good EMRs on the market. The challenge is to find them and promote them. If we (doctors) can find the good EMRs, word will spread and implementation will happen very rapidly!