Specialty EMRs: Behind The Curve?

While I’m not an academic type, a lot of research passes over my desk. That includes both anecdotes and statistics on specialty EMR adoption. From what I’ve seen, the arguments for and against specialists using specialty-specific EMRs are more or less in a dead heat.

For that reason, I was particularly interested to read this quote in a recent article on specialty EMR adoption, which cited factors why specialists supposedly aren’t buying in to practice-specific solutions:

“One, most specialists are already invested in standard solutions. Two, most specialists would not consider such applications as mature products. After all there are specialties within specialties, and then every specialty has their own way of operation. Three, specialist workflow is too intricate for extensive automation.”

I think each of these assertions are worth addressing. Taken as a whole, they suggest that specialty EMRs are way behind the curve, I think, and that’s a pretty significant claim.

First, are most specialists really invested overwhelmingly in standard solutions? This could be true but I wasn’t able to dig up evidence to support this claim.  Specialists may be using hospital-based systems, which by default puts them on a broad-based platform, but that’s another discussion entirely.

Looking at point two, are specialists looking at, say, a cardiology or ENT-specific EMR as immature by definition?  Again, I’m not sure what to make of this. I don’t have data immediately to hand, but it does seem to me that some specialties have pretty mature EMRs available to them, while others may not.  (As for the observation that ‘every specialty has its own way of operation,’ well, that’s true, but isn’t that true of primary care practices too?)

Third, we have the claim that specialist workflow is too intricate to be automated. I’m particularly skeptical of this one. It’s certainly legitimate to question whether subspecialty workflow is currently being automated well, or whether such EMRs offer flexible enough tools to allow for customization, but flat-out suggesting that it can’t be automated strikes me as fishy.

Bottom line, my instinct is that specialty EMRs have as good a chance as any to serve as a useful tool.  Arguing, in essence, that they just can’t be done right doesn’t make a lot of sense to me.

About the author

Anne Zieger

Anne Zieger

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

4 Comments

  • Against specialty solutions . . .

    Re your points :

    One, most specialists are already invested in standard solutions: (True, if two specialists merge, they will have to decide which system to use going forward, no difference between two general med clinics merging).

    “Two, most specialists would not consider such applications as mature products. After all there are specialties within specialties, and then every specialty has their own way of operation. (Yes, because the designers set too narrow a focus, but, pick a mature environment and no problem accommodating many sub-specialties with BPM, no problem accommodating “own way” with ACM/BPM.

    Three, specialist workflow is too intricate for extensive automation. (if we can build a process for a repair job on an orbiting space station that requires a space walk, surely readers will agree that is “intricate”).

  • There are a few doctors out there (one is a breast cancer surgeon) who argue that there is a great need for systems designed for given specialties. But if I understand him correctly, he would also push the concept of at least some of this being handled by add-on’s to existing EMRs. For this to work, you need standardized APIs to be able to connect the ‘specialization’ to the main EMR and do it seamlessly. And the specialization work would be done by doctors who are very tech savvy, and who want to take advantage of features already built into ‘standard’ EMRs.

    As I see it, EMRs suffer from a lack of standardization on how they interface to practice management systems, ePrescribe systems, labs, PACS, etc. And how they communicate with each other. This adds another dimension, that not only should their be standards – including in the form of APIs for the normal things like ePrescribe, there could also be the same for add on specialization.

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