Comments on: Funding electronic medical records and bailing out the Big Three automakers http://www.kevinmd.com/blog/2008/12/funding-electronic-medical-records-and.html medical blog Sun, 22 Nov 2009 14:15:05 -0500 http://wordpress.org/?v=2.8.4 hourly 1 By: plin http://www.kevinmd.com/blog/2008/12/funding-electronic-medical-records-and.html/comment-page-1#comment-89427 plin Mon, 26 Jan 2009 23:53:00 +0000 http://clients.emmense.com/kevinmd/2008/12/funding-electronic-medical-records-and-bailing-out-the-big-three-automakers.html#comment-89427 I agree with Chuck. I have been working with HL7 data feeds for the past year now and there are simply a lot of frustration instead of benefits. <br/>One way for the government to EMR might be to hold some sort of contest/competition for people to build the best EMR system instead of simply handing out the money. That way we will stimulate entrepreneurship while changing health care system.<br/>On the same topic, the amount of money charged by the drug companies for their drug dictionary is ridiculous. I agree with Chuck. I have been working with HL7 data feeds for the past year now and there are simply a lot of frustration instead of benefits.
One way for the government to EMR might be to hold some sort of contest/competition for people to build the best EMR system instead of simply handing out the money. That way we will stimulate entrepreneurship while changing health care system.
On the same topic, the amount of money charged by the drug companies for their drug dictionary is ridiculous.

]]> By: Chuck Brooks http://www.kevinmd.com/blog/2008/12/funding-electronic-medical-records-and.html/comment-page-1#comment-88981 Chuck Brooks Thu, 01 Jan 2009 17:56:00 +0000 http://clients.emmense.com/kevinmd/2008/12/funding-electronic-medical-records-and-bailing-out-the-big-three-automakers.html#comment-88981 The government’s ‘investing’ money in EMR is seen by many as a way of solving the US’ health problems. One thing the government knows how to do well subsidize failure.<br/><br/>The current batch of EMR software is pretty bad, particularly from a User Interface perspective. This front end problem can be solved fairly easily, using some common sense, open source software, and the customization capabilities that the newer Web 3.0 technologies have demonstrated and proven. <br/><br/>However (always one of these), the main problem is the back end, often called the ‘plumbing’. Every interested entity involved in health care, and there are a lot of them, wants their data in their own way. Even when these ways are stable for a while, the entities’ internal business rules and workflow processes are opaque and arbitrary, and where managed seem to be more concerned with maximizing revenue (increase enrollments) and minimizing expenses (deny more claims).<br/><br/>The failure of HL7 and its various alternatives to achieve a transparent standard of information exchange is made even worse by the complexities of the billing capturing methods such as ICD 9/10. <br/><br/>All these things do is perpetuate a never ending back office problem. Completely ignored are the needs and requirements of the patient/customers. Driven an Edsel lately?<br/><br/>Chuck Brooks<br/>FutureWare SCG The government’s ‘investing’ money in EMR is seen by many as a way of solving the US’ health problems. One thing the government knows how to do well subsidize failure.

The current batch of EMR software is pretty bad, particularly from a User Interface perspective. This front end problem can be solved fairly easily, using some common sense, open source software, and the customization capabilities that the newer Web 3.0 technologies have demonstrated and proven.

However (always one of these), the main problem is the back end, often called the ‘plumbing’. Every interested entity involved in health care, and there are a lot of them, wants their data in their own way. Even when these ways are stable for a while, the entities’ internal business rules and workflow processes are opaque and arbitrary, and where managed seem to be more concerned with maximizing revenue (increase enrollments) and minimizing expenses (deny more claims).

The failure of HL7 and its various alternatives to achieve a transparent standard of information exchange is made even worse by the complexities of the billing capturing methods such as ICD 9/10.

All these things do is perpetuate a never ending back office problem. Completely ignored are the needs and requirements of the patient/customers. Driven an Edsel lately?

Chuck Brooks
FutureWare SCG

]]> By: Doc99 http://www.kevinmd.com/blog/2008/12/funding-electronic-medical-records-and.html/comment-page-1#comment-88953 Doc99 Wed, 31 Dec 2008 16:44:00 +0000 http://clients.emmense.com/kevinmd/2008/12/funding-electronic-medical-records-and-bailing-out-the-big-three-automakers.html#comment-88953 Which will prove to be the bigger boondoggle in 2009 - EMR's or ICD10?<br/>How much longer can US docs survive the seemingly endless stream of unfunded mandates that have more to do with data tracking than patient care? Which will prove to be the bigger boondoggle in 2009 – EMR’s or ICD10?
How much longer can US docs survive the seemingly endless stream of unfunded mandates that have more to do with data tracking than patient care?

]]> By: Rogue Medic http://www.kevinmd.com/blog/2008/12/funding-electronic-medical-records-and.html/comment-page-1#comment-88943 Rogue Medic Wed, 31 Dec 2008 12:01:00 +0000 http://clients.emmense.com/kevinmd/2008/12/funding-electronic-medical-records-and-bailing-out-the-big-three-automakers.html#comment-88943 The problems with the current state of EMR is bad. Prehospital software is much more simple.<br/><br/>Since government money will probably only encourage the acceptance of faulty systems, that is another good reason to wait. The problems with the current state of EMR is bad. Prehospital software is much more simple.

Since government money will probably only encourage the acceptance of faulty systems, that is another good reason to wait.

]]> By: Howard Luks http://www.kevinmd.com/blog/2008/12/funding-electronic-medical-records-and.html/comment-page-1#comment-88931 Howard Luks Wed, 31 Dec 2008 01:38:00 +0000 http://clients.emmense.com/kevinmd/2008/12/funding-electronic-medical-records-and-bailing-out-the-big-three-automakers.html#comment-88931 I could not agree more. A big push into a HC IT spend with EMR structured and engineered the way they are would be a waste of money better spend elsewhere. My latest blod piece on this was picked up by the VC space in Seattle. <br/>http://tinyurl.com/87muzb I could not agree more. A big push into a HC IT spend with EMR structured and engineered the way they are would be a waste of money better spend elsewhere. My latest blod piece on this was picked up by the VC space in Seattle.
http://tinyurl.com/87muzb

]]> By: Anonymous http://www.kevinmd.com/blog/2008/12/funding-electronic-medical-records-and.html/comment-page-1#comment-88925 Anonymous Wed, 31 Dec 2008 00:02:00 +0000 http://clients.emmense.com/kevinmd/2008/12/funding-electronic-medical-records-and-bailing-out-the-big-three-automakers.html#comment-88925 We aren't in the universe alone. We need to look at the debacle in Britain before making any decisions. I don't know how good Vista is, but agree with the money part of it. Much of the cheerleading for health IT comes from the IT industry (I work for one them now) who are salivating at the hundreds of billions they think this will make for them-the more costly the better. They are counting on it pulling them out of the slump they have been in since the i-net bubble broke. We aren’t in the universe alone. We need to look at the debacle in Britain before making any decisions. I don’t know how good Vista is, but agree with the money part of it. Much of the cheerleading for health IT comes from the IT industry (I work for one them now) who are salivating at the hundreds of billions they think this will make for them-the more costly the better. They are counting on it pulling them out of the slump they have been in since the i-net bubble broke.

]]> By: Anonymous http://www.kevinmd.com/blog/2008/12/funding-electronic-medical-records-and.html/comment-page-1#comment-88921 Anonymous Tue, 30 Dec 2008 21:55:00 +0000 http://clients.emmense.com/kevinmd/2008/12/funding-electronic-medical-records-and-bailing-out-the-big-three-automakers.html#comment-88921 i have eclinicalworks and have used the VA's program and didn't like it at all. I don't find it great other than you can get reports from all over in the system but i imagine this is possible in any large corporate network emr like kaiser.. i have eclinicalworks and have used the VA’s program and didn’t like it at all. I don’t find it great other than you can get reports from all over in the system but i imagine this is possible in any large corporate network emr like kaiser..

]]> By: Anonymous http://www.kevinmd.com/blog/2008/12/funding-electronic-medical-records-and.html/comment-page-1#comment-88919 Anonymous Tue, 30 Dec 2008 19:23:00 +0000 http://clients.emmense.com/kevinmd/2008/12/funding-electronic-medical-records-and-bailing-out-the-big-three-automakers.html#comment-88919 VistA is a non-starter because nobody can make money on it.<br/><br/>What the government should do is set standards on data formats, security, interconnectivity, etc to allow the fixes that are needed before widespread adoption will take place, and then provide real motivation to use them - how about using the 'Gore Tax' money on wiring rural health care facilities (including doctors offices)? VistA is a non-starter because nobody can make money on it.

What the government should do is set standards on data formats, security, interconnectivity, etc to allow the fixes that are needed before widespread adoption will take place, and then provide real motivation to use them – how about using the ‘Gore Tax’ money on wiring rural health care facilities (including doctors offices)?

]]> By: Anonymous http://www.kevinmd.com/blog/2008/12/funding-electronic-medical-records-and.html/comment-page-1#comment-88918 Anonymous Tue, 30 Dec 2008 19:21:00 +0000 http://clients.emmense.com/kevinmd/2008/12/funding-electronic-medical-records-and-bailing-out-the-big-three-automakers.html#comment-88918 Given the way that most Feasibility Analysis processes are structured for IT adopting a system like VistA would almost never turn out to be cost effective.<br/><br/>You have to take legacy costs and conversions into account, as well as factor in the issues of software that was written over a long period of time in specialized or older software languages. Given the way that most Feasibility Analysis processes are structured for IT adopting a system like VistA would almost never turn out to be cost effective.

You have to take legacy costs and conversions into account, as well as factor in the issues of software that was written over a long period of time in specialized or older software languages.

]]> By: Lyle http://www.kevinmd.com/blog/2008/12/funding-electronic-medical-records-and.html/comment-page-1#comment-88917 Lyle Tue, 30 Dec 2008 18:49:00 +0000 http://clients.emmense.com/kevinmd/2008/12/funding-electronic-medical-records-and-bailing-out-the-big-three-automakers.html#comment-88917 I'm not quite sure why the VA's VistA is so often left out of these discussions. It's development was done entirely in-house so it is available to the government (and as freeware to any physician who wants to find their own IT support). <br/><br/>This money could easily be used to develop centralized IT support available to any physician who adopts the software. The program isn't beautiful, but it's inter-operable and extremely functional. I’m not quite sure why the VA’s VistA is so often left out of these discussions. It’s development was done entirely in-house so it is available to the government (and as freeware to any physician who wants to find their own IT support).

This money could easily be used to develop centralized IT support available to any physician who adopts the software. The program isn’t beautiful, but it’s inter-operable and extremely functional.

]]>