How are they planning on pushing it to hospitals? All major players have adopted Epic EMR, at least here in Colorado. And once they have a system, they'll stick with it due to premium support and huge cost will prevent switching.
OpenEMR: Electronic Medical Records and Medical Practice Management Software
31–40 of 214 posts
Re: OpenEMR: Electronic Medical Records and Medical Practice Management Software
#32Earlier quoted context omitted.
Not entirely related, but the pain of the "paper cycle" as a "customer" of health-care is real. It seems as if to avoid dealing with hipaa regulation it's all paper, fax machine, and come pick up your x-rays burnt on a cd during your work hours (cd that you have to buy). Having not grown in the states, this type of practices seems very primitive to me. Amongst many other aspects of the American healthcare, but that's…
I am actually not opposed to the "CD you have to buy" policy. If I was hospital network admin I would not want people just plugging in random usb sticks into my network.
I think the expectation is that these organizations should be able to send this data to each other. That they was put the data on a disk and then give that to a patient who the drives it over to another part of town and hands the disk over is a ridiculous waste of everyone's time.
It also highlights how far the entrenched vendors and hospitals will go to keep their customers "locked in."
Re: OpenEMR: Electronic Medical Records and Medical Practice Management Software
#33As other comments mention, this project has been going for a while, the central reason it (or something like it) has not been robustly built out and deployed universally is because of the way congress chose to structure the funding for development of EMRs/EHRs. Rather than trying to find a system that could be universalized, the (idiotic) plan has been to give millions of dollars to multiple corporations to develop s…
As a programmer for an American EHR firm -- all of the market share already belongs to one of those companies you malign. You could not have had the government sponsor some new software which would eliminate a billion dollar software market. It's a non-starter. All the hospitals already are signed on multi-year contracts with those large providers. Some of the EHR providers began writing medical software for hospital…
I think that the big push to move to EHR's was actually started by Bush. I am sure that Obama continued this push though.
Re: OpenEMR: Electronic Medical Records and Medical Practice Management Software
#34Re: OpenEMR: Electronic Medical Records and Medical Practice Management Software
#35As other comments mention, this project has been going for a while, the central reason it (or something like it) has not been robustly built out and deployed universally is because of the way congress chose to structure the funding for development of EMRs/EHRs. Rather than trying to find a system that could be universalized, the (idiotic) plan has been to give millions of dollars to multiple corporations to develop s…
>Rather than trying to find a system that could be universalized, the (idiotic) plan has been to give millions of dollars to multiple corporations to develop systems, then subsidize the purchase cost to providers to encourage adoption. Then, only once everyone has invested in their own proprietary system will they begin trying to universalize the system by developing cross compatibility. This is misinformation. Inter…
I don't think we will ever see HL7 messages exchanged between organizations. Each product has it's own list of message types that they support, and even then they will vary in terms of which segments have data and in some cases, even what that data will be. Patient identifiers also vary between organizations, making it hard to know which patient goes with which piece of data.
Alternative methods for passing data between organizations have been proposed, but the vendors as well as the hospitals have been fighting this tooth and nail. The big EMR vendors are dragging their feet (and cashing government checks) but hospitals aren't pushing for this functionality either. IMHO, hospitals also would prefer to keep patient data to themselves.
Re: OpenEMR: Electronic Medical Records and Medical Practice Management Software
#36As other comments mention, this project has been going for a while, the central reason it (or something like it) has not been robustly built out and deployed universally is because of the way congress chose to structure the funding for development of EMRs/EHRs. Rather than trying to find a system that could be universalized, the (idiotic) plan has been to give millions of dollars to multiple corporations to develop s…
> This methodology is perfectly in line with the free-market approach that the US has championed for decades.
Not really a libertarian myself, but were I to pretend for a moment that I was, I'd say that this statement of yours could not possibly be less accurate, and that federal interference of this sort is the precise, diametrical antithesis of what is meant by the phrase "free market".
Re: OpenEMR: Electronic Medical Records and Medical Practice Management Software
#37How are they planning on pushing it to hospitals? All major players have adopted Epic EMR, at least here in Colorado. And once they have a system, they'll stick with it due to premium support and huge cost will prevent switching.
Epic, Cerner and Meditech are the largest EHRs and they combined control just about 50% of the market. Epic and Cerner tend more towards the Academic hospitals and Meditech and McKesson (#4) tend towards the Commercial hospitals.
There has also been a ton of incentive payments from CMS that have almost exceeded the EHR industry as a whole.
There have also been quite a few big switches from the 90s to today, a bunch of them from Meditech/Epic/Cerner to others, so it can definitely happen.
Re: OpenEMR: Electronic Medical Records and Medical Practice Management Software
#38I'm currently working on my thesis, I'm trying to design a radically different take on EMR/EHR systems - http://barnett.surge.sh/
I've come to realize healthcare software is a significantly trickier problem than most realize. Not in terms of technical possiblity, but other factors.
Building healthcare software is really hard - which seems like such a paradox, because surely ensuring highly trained individuals have half decent tools would be a huge goal for society - but almost all healthcare software is still frankly, terrible.
After heaps of reading I've narrowed it down to 3 reasons why healthcare software is so hard to build.
1 - Modern healthcare is complex, and varied. Building any healthcare softawre is no easy task, even simple systems have many other systems to integrate with. But what makes this worse, is that no two places do healthcare quite the same. Between regions, and institutions, healthcare can vary a shit ton.
2 - Healthcare is risky. Sounds obvious, but if your software fails, people die - but this risk creates an attitude of "dont touch it". Changing systems has such a risk, that institutions will use the same software until it's so out of date its not funny. This impeeds improvement and innovation.
3 - Healthcare software is hard to sell. Not in the sense that its unprofitable, but that it takes ages to get users. Say if I made video editing software - I could get professionals trying it out tommorrow. However, if I make a PMS, I have to sell it to the entire practice - not just a few keen doctors. From making contact to actually getting a small practice using your software could literally be years - making it super hard to enter the market.
I've been working on this topic fulltime for a year now - and I must admit, I don't have the golden answer. However, I'm designing a system as a response to these factors, an alternative to interoperability, and would love to talk anybody in the industry about it.
eliot.slevin@gmail.com
Re: OpenEMR: Electronic Medical Records and Medical Practice Management Software
#39Earlier quoted context omitted.
As a programmer for an American EHR firm -- all of the market share already belongs to one of those companies you malign. You could not have had the government sponsor some new software which would eliminate a billion dollar software market. It's a non-starter. All the hospitals already are signed on multi-year contracts with those large providers. Some of the EHR providers began writing medical software for hospital…
But most physicians don't work for hospitals. They work at small practices with 10 physicians or fewer (according to the AMA). There was a completely open market, made of the majority of physicians, regardless of existing provider contracts with hospitals. I know I talked to a few physicians (and other healthcare professionals) in the mid-2000s who lamented the paperwork they had to do every day and the lack of avail…
Unfortunately with the consolidation into medical "groups" that has been going on among doctors and with the hospitals offering "deals" along side those vendors they use for the doctors to adopt them, a lot of doctor's groups have adopted whatever system they are most integrated with's EHR.
There's a ton of slimy dealings going on sadly.
Re: OpenEMR: Electronic Medical Records and Medical Practice Management Software
#40How are they planning on pushing it to hospitals? All major players have adopted Epic EMR, at least here in Colorado. And once they have a system, they'll stick with it due to premium support and huge cost will prevent switching.
Hospitals in America aren't the main consumers of OpenEMR. Think smaller facilities, and hospitals and facilities outside of the US.