As much as I would love this, I simply dont think it will work. Why? Epic is simply too big and has too much of the market and they are too far behind.
I use picnichealth.com to deal with this EMR mess and I love it!
OpenEMR: Electronic Medical Records and Medical Practice Management Software
51–60 of 214 posts
Re: OpenEMR: Electronic Medical Records and Medical Practice Management Software
#52Earlier 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…
The issue with small practices and even slightly larger physician's groups is that an EMR is often just a cost, with very little benefit.
If you're a hospital with lab facilities, imaging facilities, surgical facilities etc. it's hugely useful to have medical records flow internally (quasi-)seamlessly. The EMR does that well, and the large cost of typing things into the EMR (it's slow, painful, annoying, never met a doc who preferred it to the old clipboard and notes system) is totally worth it.
For a small practice, that intercommunication problem isn't anywhere near as large, but the cost of typing things in painfully is the same. So small practices hate it.
And before you say, "but it's useful to share medical records between offices/specialists/hospitals when they move around", it turns out that a lot of these systems don't play very well with one another. Even between two healthcare systems that share the same software provider (in this case Epic, one of the big two, the other one is Cerner), I've heard people finding it easier to print it out, fax it over, and scan it back in. Yes there are people who want to solve that problem, (see YC's own https://www.patientbank.us), but it's a tough area because who pays for the service? How expensive is it to build software that interacts with all the 10 zillion different flavors of Epic? How do you harmonize the peculiarities in how people actually record the data in those systems? It's really really hard.
Re: OpenEMR: Electronic Medical Records and Medical Practice Management Software
#53EMR is simply too messy for openEMR to put a dent in the issue. I truely wish it were different. If insurance carriers are permitted to operate across state lines in the future, i think there is a chance of a Google or Microsoft getting into the space which I think is the right way to go. Right now, the large companies managing EMR and huge monoliths that simply don't care about innovation. They are like defense contractors to the military.
If the market ever opens up and consumers have more choice, its clear that someone like google or MS would win and I honestly believe really give healthcare a boost in this country.
Re: OpenEMR: Electronic Medical Records and Medical Practice Management Software
#54Earlier quoted context omitted.
> 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".
Ah, but then you ignore the many years of deliberate effort by politicians to equate "privatization" and "public/private partnerships" with "free markets", to the point where OP's statement is perfectly reasonable in light of history.
My undoubtedly imperfect emulation of a libertarian wishes me to note in response that that's just the sort of thing which a statist politician, heavily invested of necessity in the status quo, would say, and that there's no reason why we should lend the claim credence just because it's been around for a while.
He suggested following that up with what I believe to be an Upton Sinclair quote, but I'd rather eat my supper than participate in an argument over Mises and Rothbard, so I think it's time I snapshot and terminate the running instance.
Re: OpenEMR: Electronic Medical Records and Medical Practice Management Software
#55As much as I would love this, I simply dont think it will work. Why? Epic is simply too big and has too much of the market and they are too far behind. I use picnichealth.com to deal with this EMR mess and I love it!
The pricing seems incredibly high, am I understanding correctly that they want ~$300 up front then $33/month thereafter?
That said, working in this industry, I know exactly how hard it is to do this right. In many ways this is what it costs to do the job, if not more, but I'm not sure I'd pay it. There's the tragedy of the whole EMR/patient data story: bloody expensive, who pays?
Re: OpenEMR: Electronic Medical Records and Medical Practice Management Software
#56EMR is simply too messy for openEMR to put a dent in the issue. I truely wish it were different. If insurance carriers are permitted to operate across state lines in the future, i think there is a chance of a Google or Microsoft getting into the space which I think is the right way to go. Right now, the large companies managing EMR and huge monoliths that simply don't care about innovation. They are like defense cont…
That's not how the EMR market works. Insurance sales across state lines won't make much difference to EMRs either way.
Google and Microsoft are horizontal vendors. They aren't likely to put a major effort into a vertical market, and even if they did there's no reason that they would do it any better than the existing vendors. It's not like Google and Microsoft have some sort of magic pixie dust that would allow them to overcome experienced vendors in a brutally competitive market.
Re: OpenEMR: Electronic Medical Records and Medical Practice Management Software
#57Earlier 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…
The small medical practices are rapidly disappearing. Providers are consolidating in order to have more negotiating power with payers (insurance companies), and the payers and in turn consolidating to have more negotiating power against providers, and so on.
Re: OpenEMR: Electronic Medical Records and Medical Practice Management Software
#58I'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 ha…
Your homepage there has a heavy focus on health records. Have you considered building upon the FHIR standard?
Re: OpenEMR: Electronic Medical Records and Medical Practice Management Software
#59Does anyone know of a EMR system that could house my household/personal health data? One of the struggles I have is organizing my own health data in a singular place with structured data formats, document uploads, etc.
The closest thing I have found is http://mymedicalapp.com/ but it appears to have been abandoned by the developer.
Re: OpenEMR: Electronic Medical Records and Medical Practice Management Software
#60EMR is simply too messy for openEMR to put a dent in the issue. I truely wish it were different. If insurance carriers are permitted to operate across state lines in the future, i think there is a chance of a Google or Microsoft getting into the space which I think is the right way to go. Right now, the large companies managing EMR and huge monoliths that simply don't care about innovation. They are like defense cont…
To test this hypothesis, look to California. Here we have a very large healthcare system, a variety of insurance providers, a variety of care providers and no internal barriers to insurance competition. Still, practices/insurers use different EMRs, sometimes a little different from one another, sometimes radically so. Further, providers/insurers are loathe to move away from systems they already have because of some of the issues mentioned by @JusticeJuice (currently top comment). 1.) It's super complicated 2.) It's super risky 3.) It's super hard to buy and sell, in part because of 1.) and 2.).
Even without barriers to competition, there's no consolidated EMR format or a software market with many competing players, what makes you think that opening it up nationally would revitalize the market?