To me, the following truths are self-evident.
* Hospitals will never have the same priorities as doctors. So, any EMR that works well for doctors probably won’t fit too well into the hospital view of things.
* EMRs that help doctors offer higher-quality care won’t do much to improve a hospital’s bottom line. Why? Hospitals are designed to deal with the results of poor outcomes (if not poor care).
* Hospitals really don’t care whether an EMR is designed well; their goal is to amass and manage data warehouses, not make doctors’ lives easier.
Not only that, hospitals and doctors have dramatically different ways of using EMR systems.
For hospitals, EMRs are a tool for managing flow — patients, rooms, medications, nurses, you name it.
While no one working there wants to think of patients that way, logistically they’re the key product on a factory floor. Think of a car manufacturing assembly line. Bring all the humanity you want to the process, IT managers still need to make that factory hum, today.
For doctors, EMRs are about personal effectiveness — a tool for managing and documenting a highly individualized process. Obviously, medical practices need to keep the “line” moving and patients coming in and out, but their unit of delivery is still one patient at a time.
A doctor’s EMR needs to capture their idiosyncrasies and make it easy to find the data they need. If they’re really lucky, medical practices will figure out how to use EMRs to improve care, but over weeks, months or even years. They can’t do that unless the tools they use are flexible, capable of fine-grained views of individual patient data and pretty easy to use.
Now, you tell me. Sure, doctors and hospitals are partners — and maybe some will create Accountable Care Organizations that catch fire — but will they ever reconcile their differing IT needs? I say, probably not.
And that means that sharing an EMR will always be painful, fractured experience that doesn’t really meet either side’s needs.
Of course, there is one health data solution that could bring everyone onto the same page — an HIE! Sharing the data makes MUCH more sense than trying to share an application, right? But for reasons I suspect you all know already, I wouldn’t hold my breath waiting for those spring up everywhere. It’s a real shame.