Lately the comments have been hopping with interesting conversations. Oh wait, I said that just a few posts ago. Well, it’s the truth! Turns out, a really interesting idea came out of a discussion about EMR vendor’s ability to export the data out of their system.
The basic concept is to create what I’m calling a “Provider EMR Bill of Rights”
The idea is to together create a list of criteria that would ensure that the EMR vendor isn’t just trying to make a sale, but has the best interest of the provider at heart as well. Here’s just a few examples of things that a Provider EMR Bill of Rights could include:
- Providers Always Own the Data in the EMR
- An EMR will provide a way to easily export all of the EMR data into a usable format
It might be wise to also make specific sections of the EMR Provider Bill of Rights for things like SaaS EMR. For example, we could include the following: “SaaS EMR vendors will provide a way for clinics to have a daily download of their SaaS EMR data which they can store locally.” As you can see, I’ll need your help and suggestions to make the list useful, effective and reasonable.
I think once the list of “EMR rights” is developed, EMR vendors could choose to adopt and implement these options or not. By choosing to adopt these criteria, EMR vendors would get the benefit of saying they have the providers best interest in mind. Providers will get the benefit of EMR vendors taking a stronger interest in them. Plus, providers that come upon the Provider EMR Bill of Rights will also be more informed on some of the issues they will want to discuss with EMR vendors.
I’m currently working on a redesign of this partial list of EMR and EHR vendors which I started years ago. Part of that redesign could be having a list of those EMR vendors that have chosen to adopt the Provider EMR Bill of Rights. Who knows, maybe even an icon that indicates this status and some badges to put on their website as well.
What do you think of the idea? Do you think it would be valuable? If you’re an EMR vendor, would you consider adopting this? Are there other ideas which could make this idea better?
If you like the idea, let’s start listing out items that you think should be included in the Provider EMR Bill of Rights.
Comment sent via email from Rick Milanese:
You are right on the mark regarding data management. The data should always be the property of the customer; never the vendor. It would be like Big Vendor A saying to Big Vendor B that Big Vendor A owns all of the financial data ever calculated on their mainframe. Why would it be any different for the health care industry. One downside to vendor owned data is you never know how they may use it. Would you want your information sold off to a marketing firm. I don’t.
Migrating data from one system to another is a real challenge; especially when there are no industry standards established. Having standard data would make it easier to move data between vendors but still costly. Without a standard, each vendor will build their own data base schema so another vendor will need to understand how to reverse engineer that schema then transfer the data into that vendor’s schema. Data format is another consideration. So a standard would be needed there as well. An example would be John Paul Jones can be written as John P Jones; J P Jones, Jones John P, etc. But they are all the same person. How does one deal with that if you do not know John Paul Jones personally.
The use of a standard such as IHE or HL7 would definitely be needed. Having proprietary data only locks the user into that particular system for perpetuity. Usually that is the strategy of any company is to hold customers as long as possible. Locking one in for life is not in the best interest of the customer. As a vendor that is ideal.
I’m with you about the Bill of Rights. Keep pushing and educating
Amendment 3: Training must be provided in a number of flexible ways that are inexpensive. For example, interactive DVDs that you can watch on your home computer.
Amendment 4: Vendors will provide working models of their EMR so doctors can practice doing progress notes and practice seeing patients (a limited number) prior to purchasing the system.
Amendment 5: All EMRs will provide charts to track Health Maintenance and Chronic Problem Issues. Charts to track mammograms, colonscopies and flu shots for healthy patients. Charts to track HgA1C, Eye Exams and Foot Exams for Diabetics; Stress Tests, Echocardiograms, Cholesterol Values and BP readings for Cardiac Patients.
Jeff,
Seems like a number of your amendments are too broad. If I’ve created an EMR that is focused on a certain specialty, then do I need to have charts for all of those things?
I also think the training should be up to the EMR vendor. All of them have some and by having it as part of the bill of rights how would you differentiate the various training available?
I am specifically talking about EMRs for primary care doctors. All other EMRs will be simpler and can be a subset of these requirements. We need to start with broad principles and then make exceptions when the exceptions are warrented and justified.
Training SHOULD NOT be up to the vendors! That is specifically why we are coming up with this EMR Bill of Rights. We are telling the vendors what we NEED and what we WANT. We don’t think they are giving us what we NEED and what we WANT!
I don’t think I want to focus it on only EMR sofware for primary care doctors. I think it’s best to keep it on rights that apply to all doctors.
Training is worth considering, but I think that there has to be a way to communicate, measure and ensure that they’re following this list of ideas. Otherwise, it’s just a list with no meaning.
A “GOOD” EMR for primary care can be easily customized by the doctor at no cost to be used in any specialty.
I could take SOAPware and make it work for any specialty with very little customization at no cost (other than my time which would not be that much).
Amendment 6: Primary care EMRs must be able to be customized with very little time and effort (and no cost) to fit any specialty.
If you focus on Primary Care EMRs, you will capture all EMRs. This keeps thing simple (which is important).
You MUST include training in this list. Without excellent training, the EMR is almost worthless (and gets deinstalled) and does not accomplish meanful use. Most vendors do not provide the right type of training, in the right place, at the right time.
The first six amendments. (we can always edit later)
Amendment 1: Providers Always Own the Data in the EMR
Amendment 2: An EMR will provide a way to easily export all of the EMR data into a usable format
Amendment 3: Training must be provided in a number of flexible ways that are inexpensive. For example, interactive DVDs that you can watch on your home computer.
Amendment 4: Vendors will provide working models of their EMR so doctors can practice doing progress notes and practice seeing patients (a limited number) prior to purchasing the system.
Amendment 5: All Primary Care EMRs will provide charts to track Health Maintenance and Chronic Problem Issues. Charts to track mammograms, colonscopies and flu shots for healthy patients. Charts to track HgA1C, Eye Exams and Foot Exams for Diabetics; Stress Tests, Echocardiograms, Cholesterol Values and BP readings for Cardiac Patients. Urology EMRs will provide charts that track PSA, Rectal Exam, Ultrasound of Prostate, Biopsy Results of Prostate, etc. Specialty EMRs will provide tracking charts that track important continuing care data for that specialty.
Amendment 6: Primary care EMRs must be able to be customized with very little time and effort (and no cost) to fit any specialty.
1: Providers Always Own the Data in the EMR
2: An EMR will provide a way to easily export all of the EMR data into a usable format
3: Training must be provided in a number of flexible ways that are inexpensive. For example, interactive DVDs that you can watch on your home computer.
4: Vendors will provide working models of their EMR so doctors can practice doing progress notes and practice seeing patients (a limited number) prior to purchasing the system.
5: All Primary Care EMRs will provide charts to track Health Maintenance and Chronic Problem Issues. Charts to track mammograms, colonscopies and flu shots for healthy patients. Charts to track HgA1C, Eye Exams and Foot Exams for Diabetics; Stress Tests, Echocardiograms, Cholesterol Values and BP readings for Cardiac Patients. Urology EMRs will provide charts that track PSA, Rectal Exam, Ultrasound of Prostate, Biopsy Results of Prostate, etc. Specialty EMRs will provide tracking charts that track important continuing care data for that specialty.
6: Primary care EMRs must be able to be customized with very little time and effort (and no cost) to fit any specialty.