Monday, January 14, 2013

EMR: Here Today - Gone Tomorrow?


There is a real opportunity here for EMR innovators to step up. It isn’t the size of the vendor that matters; it’s their customer centric approach. EMR systems must be adaptable to physician work flow. They must align to the process and business needs of the small 1-5 ambulatory practice as well as the large IDN.....

I’ve been involved in EMR since early adoption. I quickly found out that in order to create sustainable value for the EMR, I needed to listen to the end user, and adapt the EMR to work for each role, from front desk to back office.  More times than not, the vendor told me “Let the trainers do that, and move on to the next one”.  However, two days on site or three in a classroom wasn’t enough to create sustainable usability. Trainers provided script training, nothing more. This left physicians and clinicians to finish documentation at night or on weekends.  EMR cost more, created more work, and left the practice scrambling to see the same patient load every day. It quickly became a money pit of financial disaster.
I accompanied providers into exam rooms, or lurked right outside them, sometimes waiting in the physician office to play “Catch up” with the progress note.  I created short cuts and favorite lists, customized templates and typed up my own cliff notes version of the user guides. I catered to personal preference, aligning the EMR to role based workflow, process and practice need.  My objective was not to create an EMR user, but to create a referenceable account.  And I did that over and over again from vendor to vendor, application to application. It wasn’t rocket science. It was taking available technology and aligning it specifically to the needs of the end user. It wasn’t always simple and it wasn’t always replicable. But it was always worthwhile.
Whether the fault rests on the corporate vendors or end users is unclear. However, it is clear that people have to understand the process, and be able to create a product that aligns to usability in a real time scenario. Creating relationships means an investment on the part of the vendor. Creating usable software means listening to the people who actually use it. Many see Meaningful Use as a “Bribe” to get Physicians to use EMR systems, because they just can’t or won’t do it otherwise.
There is a real opportunity here for EMR innovators to step up. The construction of a sustainable ecosystem delivers value to the end user. Value is defined in the creation of an adaptable, flexible platform that is interoperable, physician friendly, and scalable to the environment. It’s the same scenario we faced during early adoption. It takes people with a customer centric approach, who listen to the real life challenges of practicing medicine, Then take the time needed to work with clinicians and physicians. It’s through this shared responsibility that EMR companies remain sustainable. Its through this shared responsibility that everybody wins. 

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