Custom vs Canned Softwares.

Joseph's law of Canned software:

"Most people will have to get Canned EMRs and adjust and adapt to Softwares rather than get Custom softwares".

Found out some people are finding out custom Softwares cost a ton of money and is just not worth it.

Our main local hospital found it out. They found out the custom Portal was not worth it and is shedding the project.

The EPIC project they will implement will cost 100 Million $- all said and done. Now that is 100 milliion, not a paltry amount.

Exceptions (just like all rules have some exceptions):
Cleveland Clinic EMR, discussed recently in this forum, http://www.emrupdate.com/forums/t/15219.aspx

Disney Software, discussed in Jan. http://www.emrupdate.com/forums/p/12194/77305.aspx#77305

 If you were deciding to get a car for the first time, how would you decide to get one custom made? 

Wouldn't you try a few "off the lot ones" first to get a feel for what you like/ need/ want?  It is very hard to design something custom, or tell someone else how to customize something for you until you have lots of hands on experience.  In most fields there aren't that many visionaries who can see what it could be like, if only we could stop doing "abc" and do " XYZ".

Or you can find a company that has built lots of cars and guides you through the process: you will likely get the average view of what works well enough.. and is easily maintained because millions were sold and all the mechanics were trained thoroughly and supported with technical bulletins frequently.

Perhaps buying an EMR is like buying a car.  Your first car is an introduction and probably will sustain a few dings and dents as you learn to drive it.  5 years out you know what is possible and migrate to the more complex solution: buying the Mercedes Maybach instead of the Harley Davidson Night Train.    

So if all goes well, with EMR's you end up balancing:

* Having a one of a kind that cost a fortune, is hard to maintain- cause you have the only one, but makes your life easier- fits your workflow perfectly and seamlessly.

* paying a commodity level cost, maintained and supported easily in a standard environment with standard protocols with things you have to work around.

--James

This is definitely an interesting discussion.  I've posted a few times about how I think people are crazy that want to build their own EMR (insert alborg here).  It seems to have worked well for Al and others, but for most people I still think it's crazy.  I do find the DoctorsPartner model of partial customizations to be really interesting.  I'm not sure how they manage the various customizations, but it seems like an interesting balance of the 2 competing interests.

 You could go out and build your own hammer, or yet, have someone design it for you, find the ore for the metals and then create it. Then by the time you had done all that, you'd have your own hammer making factory. That's how most EMR companies get started.