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Random Thoughts: EMR Projects Decentralized; Problems Persist Despite ‘Solutions’

Posted on August 4, 2011 I Written By

Once in a while, I run out of Big Ideas to share and resort to a rundown of short items. This is one of those times. Often, though, that approach turns out to be more interesting than a well-thought-out commentary. (Thus, the popularity of Twitter, right?)

Speaking of Big Ideas, I’m thinking that the age of the massive EMR project may be coming to an end. You may have seen my piece in InformationWeek today about the reported end of the national EMR in England. London’s The Independent reported earlier this week that the Cameron government will announce next month that it will scrap the national strategy in favor of allowing local hospitals and trusts to make independent EMR purchasing and implementation decisions.

This news comes on the heels of a decision by the government of Ontario to give up on hopes for a single EMR for all of Canada’s most populous province.

On the other hand, here in the States, we’ve seen a lot of consolidation among healthcare providers, but I’m guessing that has more to do with administrative Accountable Care Organizations and the prospect of bundled payments than any desire to build a more unified EMR. Though, consolidation does make health information exchange somewhat easier, and that’s going to be key to earning “meaningful use” dollars beyond 2013.

On a somewhat similar note, doesn’t a headline like, “Positive Outlook for Small Practice EHR Adoption” sound like a no-brainer? I mean, isn’t that the segment of healthcare providers that historically has had the slowest adoption rates? More than anyone else, small practices—particularly small, primary care practices—are the intended target of the federal EHR incentive program. And most of the news from health IT vendors of late has been about how they are going after this long-neglected market, right? The innovation seems to be happening in ambulatory EMRs, as evidenced by DrChrono’s newly certified iPad EHR app, aimed squarely at independent physicians.

That said, vendors and publicists, please do not start inundating me with news about other EHRs getting certified. There are hundreds of certified products out there now, and I cannot and will not write about, oh, about 95 percent of them.

While you’re at it, please stop using the word “solution” as a synonym for “product” or “service.” Tech journalists hate this trite, lazy and, frankly, inaccurate term so much that I’ve been instructed by the editors of InformationWeek not to use it, except in direct quotes. In fact, I get reminded not to use it pretty much every time I’m forwarded a press release laden with news about someone’s “solution.” Solution to what? I’ve been seeing that term since I started covering health IT more than a decade ago, and I still don’t see much getting solved in healthcare. With all the “solutions” out there, you’d think that healthcare had been fixed by now.

I could get a whole lot more curmudgeonly on you, but I think I’ll stop now and await your comments.


Comparison With British National Health System EMR Implementation

Posted on March 13, 2009 I Written By

John Lynn is the Founder of the 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 and John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’ve been really amazed at the number of people I’ve heard talking about the HITECH Act bringing in a “new age of EHR” and other similar phrases. Then, I usually consider who’s been saying it and I realize that their pocketbooks are going to be lined with money from the HITECH Act and EHR adoption. So, I take it with a grain of salt.

Instead, I like to look at examples to help me better understand what might happen with the $18 billion Obama’s planning to spend on EHR adoption. The best example I know of comes from the British National Health System. It’s certainly not a perfect match, but should open our eyes on government funded EHR systems.

The Examiner (San Francisco) provided an interesting editorial on Britain’s National Health Service’s HIT systems implementation:

Britain’s NHS, who have been trying to get their HIT system to work properly for the past 5 years. The cost of NHS’ HIT has escalated to 6 times the original estimate — the U.S. equivalent of $18.4 billion — to serve just 30,000 physicians in 300 state-run hospitals, a fraction of the health care providers in the USA.

HIT is such a mess that Leigh recommended funding alternative systems if matters don’t improve within the next 6 months.

A large 2003-04 study of 1.8 billion ambulatory patients discovered that the use of electronic health records provided no difference in 14 of 17 quality-care indicators, produced significantly better care in just two and worse care in one.

And, a summary of 33 studies done in Europe between 1985 and 2009 found that HIT actually causes a significant number of medical errors.

Definitely cause for concern since Britain has spent $18.4 billion on a MUCH smaller health care system. Looks like Obama should have applied his “down payment” principle to HITECH Act’s $18 billion towards EHR too.