This podcast (20 min ?) likens the Irrational Exuberance over E(M/H)Rs to the DotCom Boom.
He thinks EMRs are not that good.
He thinks they suffer from Non-User Centered Design.
He thinks what gets put in digital format is important.
He thinks Heavy Investments in IT are premature.
Now that's a man with a good eye.
Here's the guy:
Scot M. Silverstein, M.D.Drexel University,College of Information Science & Technologyhttp://www.ischool.drexel.edu/faculty/ssilverstein/failurecases/
Here's the podcast:
The Problem with EMRshttp://www.govhealthit.com/specials/silverstein/
An absolute must listen for EMR shoppers.
That is a great audio interview, and a great find by Dr. Murdoch! We have discussed most--but not all--of the valid concerns brought out in this high-quality podcast. Listen to this one, Dr. Al Borges, as Dr. Silverstein is your "brother in arms" in some--but not all--respects!
Yes, Jason, a must-listen interview for all!
Robert Gleeman, Medical Journalist for EMR Update.com Email: robert@emrupdate.com Tel: 1-650-968-6359 Skype and ooVoo user name: robertgleeman EMR progress is a matter of fact. EMR Update supports your right to know.
A GREAT interview that highlites the current hype around EMRs. I think it is because the business world recognized an opportunity but unfortunately the stated capabilities are premature.
It holds out hope that the future will be bright.
Lowell Kleinman, MD www.drkleinman.com www.old-fashionedhousecalls.com
Al is going to love this guy ! More fuel for his slide show.
Graham http://www.synapsedirect.com/ Synapse - the EMR for smart users
This is one of his examples of IT failure
‘Mother referred for delivery and management of a fetus in utero with diagnosis of hypoplastic left heart – baby born, middle of night, terribly sick, unexpectedly more wrong than expected, and with truly ambiguous genitalia. Can’t get an xray, prostaglandin-E (a lifesaving medication used in babies born with functionally absent, or obstructed, blood flow out of the heart), or any medical test, until there is a “Medical Record Number” in the computer. Can’t get one of those until we tell the computer whether the baby is a boy or a girl. And there is no way to bypass that and get on with delivering emergency care. (Unimaginable - ed.) Not the way one wants to break the news of an intersex (gender not definite) problem to a new young mom, of a very sick baby…. So I ran back to Labor & Delivery, sat down face to face with the mom, still groggy from meds and caesarian section surgery – and said something like, “Your baby is very sick, and we don’t know precisely why. And we can’t tell for sure right now whether your baby is a boy or a girl. In order to get x-rays and medications, we need to tell our computer whether your baby is a boy or a girl. Which do you want the baby to be?
‘Mother referred for delivery and management of a fetus in utero with diagnosis of hypoplastic left heart – baby born, middle of night, terribly sick, unexpectedly more wrong than expected, and with truly ambiguous genitalia. Can’t get an xray, prostaglandin-E (a lifesaving medication used in babies born with functionally absent, or obstructed, blood flow out of the heart), or any medical test, until there is a “Medical Record Number” in the computer. Can’t get one of those until we tell the computer whether the baby is a boy or a girl. And there is no way to bypass that and get on with delivering emergency care. (Unimaginable - ed.)
Not the way one wants to break the news of an intersex (gender not definite) problem to a new young mom, of a very sick baby…. So I ran back to Labor & Delivery, sat down face to face with the mom, still groggy from meds and caesarian section surgery – and said something like, “Your baby is very sick, and we don’t know precisely why. And we can’t tell for sure right now whether your baby is a boy or a girl. In order to get x-rays and medications, we need to tell our computer whether your baby is a boy or a girl. Which do you want the baby to be?
The 18 year old new mom looked me right in the eye, nodded her understanding, and said, “I want a girl.” So I said, “OK, she’s a girl. I’ll come back and talk to you as soon as we get her stabilized.”’
....
Never since have I ever designed a database with gender as a binary part of the primary key. Out in the business world, people are still doing that. And I’m sure some of those people are still trying to sell their business stuff to healthcare. Babies aren’t the only ones who might need a bypass (intersex is actually quite common), and consider the roadside bomb victims in Iraq – or any other explosive, burning trauma – is gender your first concern?
Now I don't really understand why the doc here couldn't decide himself and then change the gender later on if it were incorrect. Or would that then have lead to two patient ids because the gender were part of the key creating the id?
I noted "hits" on my website on HIT difficulties and found this site. It looks excellent.
If you found my webcast views interesting, also read this recent post on a multi author blog I write for, Healthcare Renewal, related to EMR issues. It may also be of interest: http://hcrenewal.blogspot.com/2008/04/should-physicians-reject-hospital-emrs.html
S. Silverstein
Welcome to emrupdate, Dr. Silverstein! Today I visited your website because of this thread and was very impressed- great mix of relevant articles on EMR and I really enjoyed your insight on how there are extrenuous forces affecting the EMR market in a negative manner, especially in the USA where it seems to be a polical battle. I plan to visit your site often.
I hope that politically you can help us work at bringing back the good that the EMR can offer medical care. Like anything else that has potential good, it can be abused and destroyed by people trying to make quick riches on the backs of the purchasers- physicians like us.
Jason- excellent thread!
Cheers,
Al
Al Borges, M.D.
● Oncologist in a Small Group Practice in Virginia
● My website URL: http://msofficeemrproject.com/