Everyone hates the electronic medical record • Hacker News Board

Re: Everyone hates the electronic medical record

#51

Post by danielvaughn » Tue, Jan 30, 2024, 6:28 AM UTC

duffpkg wrote: post #49

I created the ClearHealth/HealthCloud open source (GPL) EMR which to my knowledge is the only open source one to receive full federal certification. Operations (not surgery) are so incredibly bad / incompetent in most healthcare settings that software frequently gets the blame for much deeper problems. This article is a doctors perspective on how software did not fix a completely broken workflow. I don't begrudge him…

This was my experience trying to create technology in the real estate world. Realtors are the same way.

Re: Everyone hates the electronic medical record

#52

Post by YetAnotherNick » Tue, Jan 30, 2024, 6:38 AM UTC

FwarkALark wrote: post #7

JusticeJuice wrote: post #4

I wrote a thesis on EHR's 7 years ago. They really haven't seemed to improve much. I personally think a big part of the issue is actually scope, these systems are expected to do everything - medical notes, script ordering, appointment management, billing of course, and 3000 other things. This weirdly leads to a distribution problem, you can't be a serious competitor in just one area, you have to do everything. Only t…

Is this something where a public competitor might help? It surely can't be worse than private industry.

Is there any industry in which public competitor is better than private one?

Re: Everyone hates the electronic medical record

#53

Post by [deleted] » Tue, Jan 30, 2024, 6:38 AM UTC

JusticeJuice wrote: post #24

FwarkALark wrote: post #7

Earlier quoted context omitted.

Is this something where a public competitor might help? It surely can't be worse than private industry.

The UK government tried this, wasted 12.4 billion pounds over 10 years, and ultimately wrote most the project off. The dream of an EHR is just deceptively tricky, so many smart, well-funded, well-connected teams have tried and failed. ref: https://barnett.surge.sh/welcome/intro.html

[deleted]

Re: Everyone hates the electronic medical record

#54

Post by rurban » Tue, Jan 30, 2024, 6:38 AM UTC

I, as patient, love it though, the German system. In January they added electronic receipts ("Rezepte") and this was the deal breaker for me.

Lots of smaller doctor offices complained though. Only the bigger ones offer it.

Re: Everyone hates the electronic medical record

#55

Post by ako » Tue, Jan 30, 2024, 6:40 AM UTC

captaincraven wrote: post #31

Disclaimer: Worked at Epic for > 3 years. EHR’s have all the problems of enterprise software, plus some. At the end of the day, the software is made for the people who pay for it. This isn’t the patients, or the providers. It’s the admin, billing, and bureaucracy layer who get to make all the decisions. It’s not surprising that these people don’t prioritize good software. EMR’s need to do more, but the root of the pr…

Agreed, you see the same issue with other enterprise software that tries to everything: SAP (including more specialized parts like Concur), Workday, and many others. They’re trying to do everything, then are often badly configured, mostly by following internal (financial) procedures, without considering end user experience.

There’s a whole industry of tools to help you build better interfaces on top of these big systems of records to improve the user experience. So much so that Gartner has even describes it as a desired way of designing system: used to be Pace Layer model, now it’s called Composable Enterprise.

Re: Everyone hates the electronic medical record

#56

Post by FwarkALark » Tue, Jan 30, 2024, 6:40 AM UTC

JusticeJuice wrote: post #24

FwarkALark wrote: post #7

Earlier quoted context omitted.

Is this something where a public competitor might help? It surely can't be worse than private industry.

The UK government tried this, wasted 12.4 billion pounds over 10 years, and ultimately wrote most the project off. The dream of an EHR is just deceptively tricky, so many smart, well-funded, well-connected teams have tried and failed. ref: https://barnett.surge.sh/welcome/intro.html

Again, this can't be worse than private industry—that profit margin will guarantee this. I guarantee there is some other disease to blame for the waste—probably politicians of some sort invested in industry.

Of course, this does demand citizens give a shit, which seems hopeless at this point.

Re: Everyone hates the electronic medical record

#57

Post by sullivantrevor » Tue, Jan 30, 2024, 6:41 AM UTC

i design an EMR for a veterinary company based in LA. can confirm our care team gets quite upset with the software at times. it is incredibly difficult to build a great user experience for all the different positions and use cases that occur throughout the day. with that said, it has been a fun and rewarding experience over the last 4 years. we are hard at work bringing AI into the EMR right now.

Re: Everyone hates the electronic medical record

#58

Post by ako » Tue, Jan 30, 2024, 6:42 AM UTC

duffpkg wrote: post #49

I created the ClearHealth/HealthCloud open source (GPL) EMR which to my knowledge is the only open source one to receive full federal certification. Operations (not surgery) are so incredibly bad / incompetent in most healthcare settings that software frequently gets the blame for much deeper problems. This article is a doctors perspective on how software did not fix a completely broken workflow. I don't begrudge him…

How should operations be changed to address the problems?

Re: Everyone hates the electronic medical record

#59

Post by FwarkALark » Tue, Jan 30, 2024, 6:43 AM UTC

YetAnotherNick wrote: post #52

FwarkALark wrote: post #7

Earlier quoted context omitted.

Is this something where a public competitor might help? It surely can't be worse than private industry.

Is there any industry in which public competitor is better than private one?

I mean, all industries? The profit margin guarantees this. Anyone who has worked in private industry will verify its utter incompetence in the long term.

Re: Everyone hates the electronic medical record

#60

Post by FwarkALark » Tue, Jan 30, 2024, 6:46 AM UTC

timekiller wrote: post #12

FwarkALark wrote: post #7

Earlier quoted context omitted.

Is this something where a public competitor might help? It surely can't be worse than private industry.

Oh it could be much worse. You should see how bad government run HIE’s are.

Again, I don't see how a private industry per se could even possibly be worse given the demand for a profit margin. Your beef is with some other aspect of this process.