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A Call for Intuitive EMRs

Scott Mace, for HealthLeaders Media, July 24, 2012

"'EMR 2.0,' as I call it has to be intuitive. It has to adapt to the physician workflow without an army of 200 people in IT behind it trying to change the code," McNutt says. "That is not a sustainable model for us to have that many people behind the scenes creating all these boxes and screens. It has to be intuitive but we're all busy dotting I's and crossing T's.

"Even the 'Cadillac' systems for physicians and hospitals are nowhere near EMR 2.0 that I envision for the future," she adds.

McNutt hopes for some "dark-horse" software from an as-yet unseen vendor, maybe from Europe or sitting in some incubator deep inside MIT, to leapfrog the capabilities of current systems. "I could make a fortune if I could figure out who this is that's going to do that," McNutt says with a laugh.

Unfortunately, software innovators—the Amazons and Googles—only come along once in a great while. Healthcare CIOs appear to be stuck living with our current generation of imperfect software.

Another option kicked around, even more unrealistically, is to hope that clinicians adopt some kind of standardized workflow. That would help software immensely, because today's software has been constructed with layer upon layer of options to accommodate different workflows. This complexity in turn adds to the complexity of the software, of training for the software, and of trying to keep the training for the software inside one human head once training is completed.

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1 comments on "A Call for Intuitive EMRs"


Alton Brantley, MD,PhD (7/25/2012 at 12:13 PM)
Pam McNutt and Chuck Christian have hit the nail on the head. In particular, the engagement of the federal government into the development of EMRs, with the bureaucracy of federal design, certification requirements, approval of certification bodies, and the introduction of civil and criminal penalties, has created a situation where the practice of medicine is subordinated to regulatory fossilization. Alternatively, what should have been sought was a standardization of interoperability and an evolvable, versionable content structure that would enable and foster the development of exactly what Pam desires. Standards should be interoperable and overlapping so that not every software system need be upgraded to interoperate effectively - a sliding window of versions and content that enable all parts of a multi system environment to operate as each component is changed out and upgraded. Finally, coding standards that are baroque in nature like the ICD codes need to be phased out and replaced with taxonomies built in machine-parsable grammars.