Unbounded EMR choices defeat improved patient outcomes, reimbursement efficiencies

The medical industry is growing at an unprecedented pace but its ability to take care of its insured continues to be hampered by the lack of Electronic Medical Record (EMR) standardization.

Choice may be a good thing for consumers and what they have available to select from regarding items such as groceries, gas stations, department stores and motor vehicles. But, in order for medical providers to truly make advances in patient care they will need to have a smaller sampling of EMR software available.

Microsoft Office 98 Macintosh Edition

Microsoft Office 98 Macintosh Edition (Photo credit: Wikipedia)

Healthcare consumers are able to choose their doctors depending on what plan they have. What they don’t know when they sign on is the type of EMR their providers are using. This is important for a variety of reasons, not the least of which is the recent transition to the ICD-10 diagnosis medical coding model the rest of the modern world has been using for over 20 years.

The business world struggled for a period of time with non-standard office productivity software and the lack of standardization initially somewhat held back the global economy’s boom. If variation is the enemy of quality, it was certainly the enemy of the business world in the form of too much office productivity software suite choices. But, it didn’t take long for Microsoft to outmarket its rivals and install Microsoft Office as the gold standard of all things word processing, spreadsheet and presentation software in the business world.

What Microsoft and Office did for the business world’s productivity must be done by one of the producers of literally dozens of EMR software suites available today. As I said earlier, choice is good when it comes to consumers and certain goods. Choice was not good for office productivity and the business world’s advances. Nor is it good for either patients or medical providers themselves, when it comes to EMR, because it hinders the ability to be connected, to have vital information flowing from facility to facility and from provider to provider. This interconnectivity and efficient flow of critical medical data can be the difference to great advances in medical care as well as saving lives.

In order to understand what I’m suggesting, one must look back in time to when the world was still on dial-up modem Internet connections. WordPerfect was battling Microsoft Word for control of the business world at large. There were several “free” software suites available (still are) that while cost-effective, ultimately proved deficient compared to Microsoft Office. This was very much part of the plan by the Redmond, Washington software giant.

Microsoft won the computer desktop war over Apple and Linux. They also won the office productivity suite software battle, and not necessarily by offering the best product. By utilizing a brilliant strategy of frequent updates that not only quashed bugs but enabled separation from the pack in the form of compatibility problems that arose when working in and viewing .doc, .xls and .ppt file formats in other software suites, Microsoft pulled away from its competitors in a relatively short time.

Crystal 128 kspread.

Crystal 128 kspread. (Photo credit: Wikipedia)

What also permitted Microsoft dominance in the business world was its long marketing arm. Microsoft took a snack food approach to its Office business suite marketing. It drilled, drilled, drilled consumers and professionals alike until they were buying Office not always because they wanted it, but because they couldn’t avoid it. One need look no further than Apple for evidence here, as while Apple has tried to always have some office productivity software of its own on the Mac, they also allowed consumers the choice of paying for Microsoft Office for the Mac—and Apple fans did so in droves making it one of Microsoft’s most profitable software segments.

Now EMR and Office productivity software is not exactly the same thing, but if Obamacare legislation truly had improved patient care in mind, it would have had provisions for limited EMR options for providers written into the law. I would have liked to have seen a “tire sale” ideology in place when it comes to EMR. That is, doctors would have a choice of good, better and best, because, again, variation is the enemy of quality (and in this case, patient care, too).

EMR is one of the single most critically utilized tools that doctors touch each and every day. If it’s really good EMR, it makes it easier for them to do their real job—which is to see and care for their patients. Good EMR takes the worry and excess time it takes to create well-documented patient progress notes away from physicians, freeing them to do the work of treating their patients as they were trained to do.

With too many EMR choices available to physicians—some free and some costing tens of thousands of dollars after adding up training, installation, licensing and workstation deployment and maintenance costs, if the federal government was truly interested in improving patient care and consumer choice for the long haul, it would intervene and settle upon a standard of limited EMR program selection.

All we really need is good, better and best. What’s so hard about that? In the case of both business and EMR software, too much complexity is bad while simplicity is good. Remember, variation is the enemy of quality, and in this case, quality patient care.

Patients could have jurisdiction over copies of their own medical records, too, if they didn’t have to contend with being locked out of access to their records by proprietary systems that would cloak them in secrecy to all but a few, holding them ransom to the very people they are connected to and who rightfully own them.

None of this would be that difficult to accomplish. I’m just one voice, but if enough of them are heard in Washington, it could finally serve as evidence that better patient outcomes are truly closer to reality than political rhetoric.


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