Everyone’s heard about it, but nobody’s seen it — the perfect EMR. You know, the one that satisfies every doctor, integrates easily with every related hospital system, plays well with HIEs and even makes coffee for the CIO.
In all seriousness, virtually every EMR installation seems to involve systems integration problems, workflow requirements, user interface design or a baker’s dozen of additional problems that hang like a cloud of smoke over even the more successful rollouts.
In theory, you might be able to resolve these disputes by letting the staff choose which EMR they’d like to see in place. But in reality, that doesn’t work either, argues John Halamka, MD, MS, whose many titles include CIO of Beth Israel Deaconess Medical Center and CIO at Harvard Medical School. “I’ve heard from GE users who want Allscripts, eClinicalWorks users who want Epic, Allscripts users who want AthenaHealth, and NextGen users who want eClinicalWorks,” he notes.
Worse, if you let every department and clinical constituency pick what they want to include in their EMR, you end up with “an unintegrated melange of different products that make care standardization impossible,” Dr. Halamka suggests.
As nice as it would be to satisfy everyone, there’s really only one approach that works, Dr. Halamka says. IT leaders need to pick an EMR for their enterprise that meets the enterprises overall strategic goals, one “providing the greatest good for the greatest number.” Then, follow up with substantial training, education, collaboration, user engagement support and healthcare information exchange, he says.
No matter what your EMR turns out to be, it’s going to fix some workflow and process issues while creating others, he suggests. The best thing healthcare CIOs can do is simply go with smart enterprise-wide technology and help providers user it effectively.
This argument makes a lot of sense to me, at least at this stage in the emergence of EMRs. In, say, five years when key features are more standardized, it might be easier to buy “off the shelf” EMRs that please almost everyone. Or will it? What do you think?