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Physician Reaction to Meaningful Use

Posted on March 30, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

An EHR vendor recently got some bad news about a doctor who chose not to implement EHR. In the response, the doctor gave them this message:

“Meaningful use is the destructive component that all of medicine should be fighting as it clearly prevents the EMR from achieving it’s potential.”

My gut reaction to this comment is: He’s right.

I’ve often talked about how meaningful use and certified EHR have hijacked an entire EHR development cycle. That means that all 300+ EHR companies had the same development list for that time period instead of focusing on creating a broad variety of innovative solutions for doctors and patients.

I imagine some would argue that EHR vendors had a lot of years to create innovations and they fell short of doctors’ expectations and so meaningful use will get them to implement features they should have implemented long ago. In some cases, this is accurate. I actually love meaningful use stage 2’s focus on interoperability. A feature that should have been developed long ago and should have been. Although, on the whole I think we are missing out on a lot of potential benefits that EMR could provide an office because the EMR developers aren’t being allowed to innovate.

I’d also argue that our billing system has had that same effect on EHR. Instead of developing EMR software that will improve patient care, it was built to maximize reimbursement.

Going back to the doctor mentioned above. While I can agree that meaningful use diminishes the value of what an EHR could potentially provide a clinic, that doesn’t mean that the EHR doesn’t still provide value. That’s like saying that a $10 bill isn’t worth as much since with an extra 0 it would be a $100 bill, so I’ll throw out the $10 bill because it’s not providing all the value that it could provide if they’d done something a bit different.

At this point, I always refer back to my list of EMR benefits. There are benefits to EHR adoption beyond government handouts. Although, for some reason we get all crazy when the government starts handing out money and forget about other outside reasons to do something.

More EMR Software On the Way

Posted on November 27, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

One of my all time favorite posts I’ve done was called “Develop Your Own EMR….Are you Crazy?” Hard to believe that was back in May of 2006. I should go back and check out the content of that post, but the title still rings very true to me. Of course, every entrepreneur that I know is a little bit crazy, so it should come as no surprised that I’m hearing all the time about new EMR software getting ready to hit the market.

Today’s encounter has to be one of the most unique. I was going to church in another state (visiting family for the Holidays) and I ran into one of my high school friends at church. We caught up and I learned that he’s the owner of a software development company. Then, as he learned what I was doing he just mentioned off hand that they were developing an EMR.

After I picked myself up off the floor, the meeting at church started so I didn’t really get a chance to talk to him. Since he’s my friend on Facebook (you know, a real friend that I know in real life type of Facebook friend), I sent him a message and hopefully we can connect. I’m really intrigued that his software development house is doing an EMR for someone. Obviously, now I have a ton of questions for him about the project. He did say before the meeting started that “it’s a BIG project.”

Of course, the message here is that there are a lot of people out there that are crazy (no offense intended) enough to start building another EMR. The problem is that there are so many doctors that are dissatisfied with the EMR software that’s out there, I’m sure until that’s resolved we’ll see more and more EMR software entrants. Oh, if only these brave souls knew what they were getting themselves into. I guess maybe that’s the beauty and key to entrepreneurship and why I love it so much.

Managing EMR Software Enhancement Requests

Posted on October 15, 2009 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

One of the huge challenges that an EMR software vendor has is the long lists of enhancement requests that they receive from end users. Managing these requests has got to be one of the most challenging jobs of any EMR vendor’s development and support teams.

An EMR vendor has so many often conflicting motivations related to which enhancement requests they add to their product. I won’t go into all the details of their job here, but let’s just say they’re walking a very small tight rope. On one side, they want to be able to create enhancements that will sale more product. On another they want to keep their current users satisfied. On the other, they don’t want to make their product to specific to one area, region, specialty (unless it’s specialty specific), insurance plan, provider type, etc etc etc. Another side wants to be able to keep innovating the product in ways that weren’t suggested by the end users. Then of course each EMR vendor wants to keep some of their enhancement plans private as part of their “competitive advantage.”

Honestly, none of this is new to software or EMR. We’ve been dealing with this for a long time. However, I don’t know of any EMR company that really manages this process well. That said, I’d love to hear about other EMR vendors approaches to collecting, managing and implementing software enhancement requests.

Here are just a few of the components that I think a good EMR software enhancement request system should have:

  • Simple, but complete method for requesting ehancements
  • Translation of the enhancement request into actionable enhancement (this is also important for helping to filter out repeats and other such noise)
  • Feedback to the end user of what was done with their request
  • System for users of the EMR to see all the enhancement requests
  • Method for users to be able to support enhancement requests that are already made (this helps an EMR vendor prioritize the requests)
  • Method for users to provide comments on already created enhancement requests (ie. refine and improve the existing requests)
  • Internal enhancement plans are part of the system
  • Completed enhancement requests are noted for those interested in following the progress

As I was listing these things I think that my view of enhancement request is partially clouded by open source projects (maybe there’s an open source EMR that does the above well?). However, I think that a number of open source projects do a really good job of managing enhancement requests. The non open source software world can learn a lot from open source software in this area.

I think one of the key things I’d love to see an EMR vendor do well is involving the “crowds” of EMR users (coined “crowdsourcing”) in the prioritizing and planning of future enhancements. Users of an EMR have a wealth of knowledge related to the product and I’ve yet to see an EMR vendor tap that knowledge really well.

I think doing the above would solve a common phrase I’ve heard after doing an EMR software update: “Why did they add that feature?” followed by the question “Why don’t they add this?”