Electronic Medical Records And Government Subsidized Failure
The government’s ‘investing’ money in EMR is seen by many as a way of solving the US’ health problems. One thing the government knows how to do well is subsidize failure.
A recent blog entry at KevinMD seems to commend Obama for wanting to modernize the US’ health records system. While the intent may be noble, the results may be in be careful what you wish for category. Odd that goverments always want to clean up any mess that they created by policy in the first place.
The current batch of EMR software is pretty bad, particularly from a User Interface perspective. This front end problem can be solved fairly easily, using some common sense, open source software, and the customization capabilities that the newer Web 3.0 technologies have demonstrated and proven.
However (always one of these), the main problem is the back end, often called the ‘plumbing’. Every interested entity involved in health care, and there are a lot of them, wants their data in their own way. Even when these ways are stable for a while, the entities’ internal business rules and workflow processes are opaque and arbitrary, and where actually managed seem to be more concerned with maximizing revenue (e.g., increase enrollments) and minimizing expenses (e.g., deny more claims).
The failure of HL7 and its various alternatives to achieve a transparent standard of information exchange made worse by the complexities of the billing capturing methods such as ICD 9/10.
Government investments in software, any software, have been amazingly bad from the beginning. The reasons are not hard to find, and in fact are generally obvious from the beginning. Still, hope springs eternal, and those in charge never have to say they’re sorry or worry about where the next pile of money will come from.
Because the government has a commanding influence on US healthcare, its fingers are in all the pies, with all the impedimenta of studies and committees and symposia and conferences and reports and reviews that bureaucracies need to survive. It’s no wonder that the current crop of EMRs are so pitiful.
All these things do is perpetuate a never ending back office problem. Completely ignored are the needs and requirements of the patient/customers.
Driven an Edsel lately?
In sharp contrast, one doctor has developed a color coded paper system that is pretty slick, and does not have the complexity or costs, both initial and ongoing, of EMRs.
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Tags: edsel, electronic medical records, emr, government software, health industry, hl7, icd10, icd9, software failures