The following appeared a little while ago.
A Call for Intuitive EMRs
Scott Mace, for HealthLeaders Media , July 24, 2012
I've previously remarked that software can't do it all—resolve all antiquated workflows or figure out stumbling blocks in people and politics. Unfortunately, that's just what EMR software is about to be asked to do.
Software is a funny thing. Done well, it anticipates the needs of human beings, or other software, and responds in flexible, flowing harmony.
Done poorly, software epitomizes everything wrong with modern society: impersonal, inflexible, regimented, mundane, boring, even maddening.
Where does your electronic medical record software wind up on that spectrum? Chances are, it doesn't look so good in comparison to your searching experience on Google or your shopping experience on Amazon.
"We need the EMR that's going to intuitively know the way our physicians practice and know the difference—and not every time a physician wants a change, we get a call, and we say we'll take that to the team, and the team will analyze it, and then the team will take it to the programming team, and in about a month, we should have your change put in our system," says Pamela G. McNutt, senior vice president and CIO of Methodist Health System in Dallas, Tex.
Software is a funny thing. Done well, it anticipates the needs of human beings, or other software, and responds in flexible, flowing harmony.
Done poorly, software epitomizes everything wrong with modern society: impersonal, inflexible, regimented, mundane, boring, even maddening.
Where does your electronic medical record software wind up on that spectrum? Chances are, it doesn't look so good in comparison to your searching experience on Google or your shopping experience on Amazon.
"We need the EMR that's going to intuitively know the way our physicians practice and know the difference—and not every time a physician wants a change, we get a call, and we say we'll take that to the team, and the team will analyze it, and then the team will take it to the programming team, and in about a month, we should have your change put in our system," says Pamela G. McNutt, senior vice president and CIO of Methodist Health System in Dallas, Tex.
"'EMR 2.0,' as I call it has to be intuitive. It has to adapt to the physician workflow without an army of 200 people in IT behind it trying to change the code," McNutt says. "That is not a sustainable model for us to have that many people behind the scenes creating all these boxes and screens. It has to be intuitive but we're all busy dotting I's and crossing T's.
"Even the 'Cadillac' systems for physicians and hospitals are nowhere near EMR 2.0 that I envision for the future," she adds.
McNutt hopes for some "dark-horse" software from an as-yet unseen vendor, maybe from Europe or sitting in some incubator deep inside MIT, to leapfrog the capabilities of current systems. "I could make a fortune if I could figure out who this is that's going to do that," McNutt says with a laugh.
Unfortunately, software innovators—the Amazons and Googles—only come along once in a great while. Healthcare CIOs appear to be stuck living with our current generation of imperfect software.
Another option kicked around, even more unrealistically, is to hope that clinicians adopt some kind of standardized workflow. That would help software immensely, because today's software has been constructed with layer upon layer of options to accommodate different workflows. This complexity in turn adds to the complexity of the software, of training for the software, and of trying to keep the training for the software inside one human head once training is completed.
"Even the 'Cadillac' systems for physicians and hospitals are nowhere near EMR 2.0 that I envision for the future," she adds.
McNutt hopes for some "dark-horse" software from an as-yet unseen vendor, maybe from Europe or sitting in some incubator deep inside MIT, to leapfrog the capabilities of current systems. "I could make a fortune if I could figure out who this is that's going to do that," McNutt says with a laugh.
Unfortunately, software innovators—the Amazons and Googles—only come along once in a great while. Healthcare CIOs appear to be stuck living with our current generation of imperfect software.
Another option kicked around, even more unrealistically, is to hope that clinicians adopt some kind of standardized workflow. That would help software immensely, because today's software has been constructed with layer upon layer of options to accommodate different workflows. This complexity in turn adds to the complexity of the software, of training for the software, and of trying to keep the training for the software inside one human head once training is completed.
Lots more here:
I am quite sure I don’t know how to fix this problem - but I certainly know it needs to be fixed. Just consider the NEHRS if you want an example of the worst sort of “impersonal, inflexible, regimented, mundane, boring, even maddening” software.
One thing is certain - the Health IT Industry needs help from all sorts of experts from other domains to do better than what is typically delivered!
David.
