Having devoted 10 years of my life to the Electronic Health Record (EHR) space, I have seen many EHR product vendors come full circle backwards. And in my opinion this is great for Health Information Exchange (HIE), hospitals, provider groups and patients.
Early EHR (EMR, CPR…) development focused on delivery of complex products that were designed to manage every task in a provider setting. Work flow features were especially complex and have had a lot to do with the large number of early failures in this space. The design process at that time revolved around a “do everything” philosophy. Not to say that there weren’t some folks preaching a different religion – but for the most part you saw complex products, requiring heavy duty hardware and large implementation projects.
And before I make my point, let me say that I was one of the people driving those complex products. In my market at that time, those products were and still are a great fit for medium to larger size provider groups looking for ways to transform their practices. Implemented correctly, those products provide immense value. And groups using these systems are certainly a large part of the connectivity plans for HIE’s.
Today however, we are seeing these vendors either acquiring or deconstructing their products to deliver the modules that users desire. These modules vary among vendors, but you typically see ePrescribing/Formulary, Results/Orders, messaging, patient portals… that are easy to implement, browser based and low cost. This is what the small provider groups were asking for 10 years ago. They want technology that allows them to run a better business and to improve care without taking out a second mortgage. And remember that these small groups make up over 50% of our providers.
I also find it interesting that these types of modular products fit very well into the current HIE development plans. Rather than select complex products that will limit adoption and prove costly and time consuming to implement – a simple web based product, consisting of modular features can be deployed cost effectively which will allow for higher levels of user adoption, better use of limited financial resources and due to the high levels of user adoption, the quality of care benefits that are driving the HIE funding.
I think it it would also be useful to replace the term “HIE” with “Hospital” or “Health System” as it relates to providing technology to non-owned ambulatory providers. Rather than try to force feed complex systems onto smaller provider groups, give them what they need to get them connected to your organization. You’ll save money, the providers will get what they want and patients will benefit.
Of course it is never easy. You still need to invest in a solid system framework to support scalability, analytics and integration. And the number of vendors that need to be evaluated can certainly be confusing. But once you get through the planning, you can expect more success by sometimes going with less.
