As I’ve been writing and reading about ARRA and the HITECH Act, I’ve had a few moments to consider the impact that things like the HIT Policy Committee will have on the future of EMR adoption in the US. Between that committee, ONCHIT and HHS the decisions they make will have far reaching impact on EHR adoption. I’ll leave the question of whether they’ll have a good or bad impact to another post.
Instead, I couldn’t help but wonder what impact bloggers and various EMR related websites and forums can have on EMR adoption. More specifically, I’ve been asking myself what kind of impact does this blog have on overall EMR adoption including both selection and implementation. Maybe I should be asking myself the question of how much impact could EMR bloggers have on influencing the HIT policy committee, ONCHIT and HHS, but I think that’s basically falling on deaf ears.
Instead, I think that bloggers like myself can have a real lasting impact on specific readers lives. Hopefully those who visit my blog get a better understanding of why they should implement an EMR. I hope they find some guidance on how to select an EMR and avoid various EMR sales miscommunication. At a minimum, I think the people who have bought the high volume scanners I suggested will be really glad they found this blog. I’m not sure why else people visit this blog.
Maybe this is all a little too personal, but I’d love to hear people’s thoughts on the impacts blogs and other EMR related resources have on EMR adoption. I’d like to think that blog like mine can have a good impact on the EMR world and aren’t just a nice place for those in the industry to sit around the virtual water cooler.
Either way, as I write future posts, I’ll be taking some of this into consideration. I think this will also give me a little bit of added motivation to complete a series of e-Books on EMR selection and EMR implementation. Hopefully those can provide some real targeted and valuable information to improve those two vital areas of EHR adoption.
Well, I’ll start by confessing I don’t see what this question has to do with anything!
I know you’re a smart person, so I’m sure I’m missing something. Care to enlighten me?
Just make sure that you begin with the costs of implimentation of both an EMR and a c-EHR, respectively, and how HITECH barely scratches the surface of c-EHR cost of implimentation.
You should also mention that the failed installation rate is about 50% (as mentioned in about 5 different sources), the deinstallation rate is 8% (1 source), and if you are lucky enough not to crash and burn, only 10% of users will use all the features enough to come close to being “significant users”… which translates to only 4% of physicians being eligible for possible “significant use” category. Of course, you have to have enough of a Medicare population to qualify, but that’s another story…
Al
Hi Al – the following doesn’t in any way contradict (or even argue with) anything you say. I’ve never even seen an EMR system. Having said that:
As someone who’s spent decades introducing new technologies to various industries, it seems clear to me that the high failure rate of these systems indicates that the systems are poorly designed: not created to solve specific worthwhile tasks, and released into the field before a large population of users have said “Yeah, this is great.”
I’m all for getting our data online, and all the good things that can happen as a result. But let’s none of us be fooled by thinking that a crummy or marginal system is made any better by having an incentive to install it.
Here’s one test: if it were FREE would you take it?
e-Patient Dave,
I’m surprised you don’t see the interesting parts of this question. You don’t find it interesting to think about the impact that blogger can or can’t have on EHR adoption? Certainly this post is full of my personal musings about what I’ve built in this blog over the past 4 years. If you don’t find that interesting, that’s fine. I’ll have another fresh blog post for you tomorrow:-)
Al,
It sounds like you’re talking about an e-Book of it’s very own. Essentially one that answers the question “Should I implement an EHR?” Could possibly be the most popular book of all. Lots to cover in it as well. Benefits of an EHR. Challenges of an EHR. Costs of an EHR. I think that might be the first one I do. Thanks for pointing it out.
“if it were FREE would you take it?”
This is a really good question. They tried it with Vista (VA EMR). I don’t know of any small offices that have adopted it. I’ll have to think about this one some more.
In one word: NO!
My reason is that I have a MS Access EMR/PMS that I’ve developed over the years that works really well. I don’t want to give it up to use someone else’s idea of how I should chart or store data… ESPECIALLY Obama’s idea which includes universal healthcare.
If it were free and they paid me $44000 a year to use it, well, maybe. Throw in a car, 12 virgins when I die, an education for all of my children, cruise vacations (note plural), then I’ll sideline my system anytime, even for the annointed one [Obama]!
Al
So, John, I confess that when I first came here last night (having spotted your tweet about it) I didn’t read deeply enough. Indeed, you mused. When I read more carefully this morning (via wifi on a bus to the airport, woohoo!) I clearly see that bloggers can have an impact on adoption.
And I confess last night that part of my motivation was to get discussion started, since nobody else had even burped yet.
—Al, as someone who’s always had to earn a living by giving people good REASON to buy something, I couldn’t agree more that these systems *must* solve some problem that people WANT to solve, or it’s all a non-starter.
Re VistA: all I know about it is its history, as recounted in Phil Longman’s Best Care Anywhere. I reviewed in a short five part series on my personal blog. He relates that the system was created in basements to solve very specific serious problems, automating things that the docs needed to do many times over, so they could cope with understaffing. It’s a $10 book at Amazon, a quick and energizing read. One could ask how well today’s systems match that template, as opposed to being bloatware: packed with interesting features that people don’t actually need to do a lot, and which users can’t understand.
From a purely business standpoint (setting aside the issues of medical practice for a moment) docs are, after all, the market. And I know what happens when companies try to provide something the market has no interest in.
Perhaps we can spread this question on a slew of blogs: “Would you take it if it was FREE?” If the answer to that is no, we’ll be doing a huge favor to EMR vendors, whether they like it or not.
I personally believe in what good data-driven and data-supported systems can do, but if there are few-to-none in the “good” category, let’s holler about that.
[Yikes, I wrote a post-length comment.]
[…] Blogger John at the “EMR (EHR) and HIPAA” blog posted a musing that caused my business antennas to twitch. A vigorous discussion has started in the comments. […]
Free? The issue is a quality issue! Everyone wants to give up in the beginning. You just have to be motivated to stick to it and bring up different parts of the system at a time. EPM, then EMR and ICS and so much more … We have been on EHR since 2006 with a back up from an IT company TSI Healthcare. Why doesn’t all these blogs talk about service?
Never go back to paper!
Determination definitely plays a huge part in a successful EHR implementation. If you think service is important, then you’ll probably enjoy my previous post about doctors left to Sink or Swim after an EMR purchase: https://www.healthcareittoday.com/2009/05/13/sink-or-swim-after-emr-purchase/ So, I guess I’m saying that we do talk about service some.
However, the money issue is still a huge issue as well and is an easy one for doctors to cite as being the problem.
FREE?
No. And this is true for the case in Massachusetts at a pilot district through the BIDMC. According to Halamka, originally they were going to pay for 85%, and no physician practices would adopt it;
then later with regulations and subsidies, they were able to pay for 100%, in other words, FREE, they again tried going up to the physicians, this time the answer was still.. NO.
Finally, this time, they said they would like them to adopt EHRs, and this time they may even get reimbursements from it, as in the stimulus, now finally, the physicians said OK, if you are paying us to adopt it, fine we will do it. …..
Interesting background J. I guess we’ll see how many doctors really do bite at the stimulus. It’s still too early to really know. Interest in EHR has grown tremendously. Actually buying of EHR not so much.