This is an interesting study in design and healthcare IT but lacks a clear roadmap for successful implementation – something that businesses require but design competitions can ignore.
“The results of a contest sponsored by the White House shows how powerful a dose of design can be in treating what ails our medical system.
Electronic medical records (EMR) are extremely useful tools and can help improve patient care and reduce costs — if designed and used properly. Unfortunately, good design is hard to come by in this market. Health IT data standards, privacy laws, and impenetrable health systems complicate an already challenging design process and usually lead to lackluster products.”
As the article refers to it, the “mundane” electronic medical record is becoming increasingly important as more test results, physician notes, imaging results, and patient records exist only in digital format. And everyone probably remembers the financial incentives that the Affordable Care Act dangled in front of physicians to persuade them to adopt EMR technology.
One of the key questions is who is the customer for an EMR? That’s complicated…but that’s who gets the attention from the EMR vendors, because they pay the bill. Sometimes it’s the physician or practice who pays for the system, sometimes it’s a healthcare system like Providence or Group Health here in Seattle, and sometimes the patient can be the (non-paying) customer. After all, the data belongs to the patient, right? But from the perspective of the entity paying for the EMR, does patient satisfaction really matter? Just like many things in healthcare (and technology for that matter), the consumer is the product, not the customer.
Some of the biggest issues preventing widespread acceptance of EMRs and more enthusiastic innovation in the market segment, in my opinion, are interoperability among disparate systems, lack of standards, data portability, and switching costs for the EMR owner. EMR vendors have not historically made it easy and simple to transfer records among competing systems while there is a confusing absence of standard fields and features from vendor to vendor. Patients switching to a competing system because of relocation or changing insurance plans or new specialists or switching primary care providers often have a difficult time accessing old records in the new system. Finally, physicians who switch to new EMRs have reported having to pay high costs to import and remap their old EMR data into a new system, a cost that has been referred to as “ransom.”
The benefits to EMRs are many, as the article suggests: easier management of chronic diseases, improved communications, better patient compliance, fewer medical errors, reduced waste because of duplicate and uncessessary tests, and lower overall costs to the healthcare system. Benefits to the advanced EMR concepts discussed in this article are potentially even more valuable. Will we see them in the near future? As a consumer and occasional patient, I sincerely hope so. As an industry observer, “the doctor will be with you shortly.”
I’ll be discussing more about the different types of customers involved in medical device commercialization in the next post in my ongoing series, Commercialization 101.