"Doctors should hate the current raft of electronic medical records. They are generally unhelpful and do not provide the benefit they should. The basis of the problem is that the information technology vendors all have their own ideas that fit within their technology limitations and can’t see beyond this. Pair this with the failure of interoperability and you get something that is not workable in reality. Without the complete information from all medical sources, how can a physician review priority variables?
Omissions because of lack of interoperability are key. Because the practice of medicine is an idiosyncratic art form, the "perfect" disease without co-morbidities is a fallacy, and yet most EMRs are based on the concept of the perfect example, in isolation. And information is stored variably, from tabular numeric pathology results to staging protocols to text notes. How do we bring together the essential information, in its necessary format to enable a pre-encounter review, understand status and the nature of the problems—not necessarily the diagnosis—and what we are doing to treat them is vital.
Because the vendors have not cracked this nut and because they are too busy trying to sell what they have instead of solving the problem, we have products that are clumsy, require too much time and effort, and don’t deliver on results.
There are answers. The technology exists, but we need someone to bring it together and make it professionally useful. And, yes, doctors are smart people. That’s why they don’t want to use something that doesn’t deliver the outcome.
(emphasis added)
The "build or buy" question is always with us. Given Mr. Bingham's analysis, it sounds like there is still room for an optimal solution to emerge, but I would not yet leap to the conclusion that we can or should build it ourselves. I think we should start by assigning a cross-functional team to evaluate the existing products in the marketplace -- now!
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