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I don't really know where to go or what to do here ....
I feel like I have Alzheimer's.
Where's the party?
What happened?
Hal3: I don't really know where to go or what to do here .... I feel like I have Alzheimer's. Where's the party? What happened?
I think folks are going through post-selection process. They've selected an EMR - (we would like to know which one) - They're going through training, implementation and review following their investment. They need some encouragement to relate their experiences.
These are the new questions EMRUPDATE wants to ask.
Nick
Nick Harrington email me or Skype: nickharrington emrupdate.comIf I have seen further it is by standing on the shoulders of Giants" Sir Isaac Newton 1676
Nick,
Times are achanging. I think a recent install is a good example. The group purchased a decently well-known EMR and it failed. So they went with a second well-known EMR and it failed. Both were certified. Both had a very active sales team. The second one flew in some upper level sales people from the coast when there was talk of deinstall.
After spending half of the national debt and a looming closure of the practice, they called in a consultant. He made his recommendation. They did their demo and they asked the really hard questions-- show me how to create new clinical content, show me how to create a new template, edit an existing one, how to fax a single encounter to another practitioner, then multiple encounters but not all encounters of a patient, track any lab value over time, send a reminder to a staff member, assign faxes and scans, etc, etc. Their list was very long. They did not want to hear promises and they did not want a canned demo. They wanted to see the software perform the steps that were lacking (but promised present) in their previous software.
The underlying theme here is that practices believe that certification is truly a functional seal of approval. It is not. Secondly, because certification exists and so many EMRs (>450) are certified, it implies a mature product offering-- like buying a hard drive or a computer. You can expect certain functionality to be present simply because the maturity of the market would have eliminated the company. Unfortunately, just the opposite is true.
With the growth of certification, EMRUpdate lost relevancy. Word of mouth (on forums) was no longer needed. The government arrived to help.
Just this week I learned that a very large practice in our town is out shopping another EMR. Yes, they have a certified one, but they certainly aren't paperless.
Functionality will become the watchword of EMR, not certification.
EMRUPDATE flew along while people were on the hunt for an EMR. Even the fruit and nut cases who advocated against EMR have either been sectioned or (hush) very quietly adopted some sort of EMR. Therefore we have to find a new niche for our EMR dicsussions.
mchasemd: The underlying theme here is that practices believe that certification is truly a functional seal of approval. It is not. Secondly, because certification exists and so many EMRs (>450) are certified, it implies a mature product offering-- like buying a hard drive or a computer. You can expect certain functionality to be present simply because the maturity of the market would have eliminated the company. Unfortunately, just the opposite is true. With the growth of certification, EMRUpdate lost relevancy. Word of mouth (on forums) was no longer needed. The government arrived to help. Functionality will become the watchword of EMR, not certification.
That sort of suggests we could still have a relevance of people changing EMRs put their hands up and explain where their choice fell way-short of requirements. However, we accept that times do change and EMR discussions don't seem to have a currency of value today. Maybe that will change if we can highlight where a blind faith and trust in certification will let down a practice.
You make the important point that selecting the wrong EMR can and probably does bankrupt a few practices, and not just the small ones. To roll through two EMR implementations must have close to killing that company.
I haven't seen any reported EMR failures. Today, both the EMR Vendor, Consultant implementing the EMR and Doctor's practice are doing everything to sweep this under the carpet.
I think it right and proper that Doctors pass on information they have about EMR installs that have gone bad. This is the place they can do this.
I'm not sure the reason that others left, but from my end my websites have picked up to the point that I just don't have time to return to EMRUpdate much anymore. I think the thing missing from EMRUpdate now is people like DrM, Al, Lowell, etc who would start the discussion around an array of interesting topics with really smart people like Cyath, Matt, Brenden, etc providing commentary on it. To be honest, I find that's basically what I'm doing on my network of healthcare IT websites now. I start the conversation and smart people (and a few not so smart ones) give their thoughts in the comments. What I don't understand exactly is why my sites are still kicking so strong and EMRUpdate is dieing a slow death. Although, this conversation starter piece is one key. However, even if you start great conversations and don't have the audience to continue the conversations, it's hard to get that audience again.
John LynnEMR and HIPAAEMR and EHRNew Blog Network: Healthcare ScenePhysician Websites made Easy, Professional, and Affordable
A little self-advertisement there John?
We're still pulling the daily visitors peaking at @1,000 per day. So we still have archvie content that's of use and being resourced. Much appreciate it if you didn't declare emrupdate.com a (Monty Python) dead parrot when there's life in the old bird yet. You sure do reference us plenty!
Hmmm.
Yes, I guess reading it now it was a little self advertisement. Although, that wasn't the intent.
There's certainly still life in the traffic and domain. It's the conversation which seems to have died. Turning that traffic into conversation again is the challenge.
I do reference EMRUpdate with fond affection. Those first 1000 posts on EMRUpdate were my education in the EMR industry. I certainly wouldn't be where I'm at today without it.
Hi,My name is Nick from Australia. I am 22 years old and am still a student.I want to join in this forum to learn more knowledge and have more friends.Look forward to being a part of this community.
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Welcome Nick!
We're always interested in perspectives on Healthcare from different regions.
Welcome to the community. Don't forget to check back daily for our updated EMR News on the home page.
Thanks,
I think Harrington has a point. Some people have plunked down the $5,000.00 - $20,000.00 to buy an EMR and are trying to wrap their heads around it all. I do hope they come back here to tell the good, the bad, and the ugly of what their experience was.
With so many EMR's certified the real question is which ones will deliver the goods. Which ones will make a practice more efficient or at least not make things worse. Unfortunatley, for many practices the worst issues aren't with the software, it's with the doctors using it. Many of them do have unrealistic expectations, poor if any IT support, and are overall just walking in with a glass-half-empty attitude. It will be interesting to see all four sides of this square play out.
Another issue going on is that many practices are also in the middle of upgrading IT as well as trying to select an EMR. Most of our clients that we do billing for have six or so year old servers and workstations that have been poorly maintained for years - if they were maintained at all. Now that those machines are finally giving up the ghost, the practices are having to replace them and do the one thing none of them wants to do - spend money on IT. Nevermind the fact that the machines they had they kept for 6 or so years.
Couple that together with yet another problem I'm seeing which is the fallout of qualified IT personell. Many of the "IT guys" out there know Windows XP like the back of their hand, but are utterly lost with Windows 7 and Windows Server 2008 R2. Many of the IT guys I hung out with back in 2005 aren't around any more and the biggest reason is failure to keep up with technology. As the new stuff came out, they ignored it. "Windows XP will be around forever!" they said. Not so, obviously.
I'm not certain how long this lull will continue, but I think it safe to say it will be a whlie. However, what's old will be new again. I can easily see EMRUPDATE regaining some serious thunder in times to come.
JamesNT
Regards, JamesNT
James, some useful observations.
I've recent experience of customers spending literally nothing on IT but then wondering why emails don't get delivered, they cannot connect to that machine, or cannot add a new printer. With IT infrastructure dating back to Windows 3.11, all kinds of malware lurking on machines with antiquated anti-virus software, they wonder why software resellers run a mile when asked to help install software.
For any small organization, they have to partner with an IT company or contractor resource or learn how to do these jobs themselves. I refuse to even go near them. Even the simplest of jobs becomes a string of follow-up "and while you're here, could you". I know there's many IT Health solo-contractors who have had the same experience. These are the types of company for whom VMWare appliances are designed for. Something that can be restored back to good-state before they started experimenting. Put the EMR application on a dedicated hosting service so they can do as little damage as possible.
We stopped any major "thick-client" application development about 2-years ago. Unless we're being paid up-front, we're unlikely to risk building anything but web-based, cloud-based or phone-based applications.
(Apart from Android and iOS development) It all sounds like we're back to the 1980s writing for centralized mainframe (now web) applications.
What a changing world.
You're exactly right. I have experieneced those exact issues with the clients we bill for. In fact, about twice a year, one of them manages to beg my boss with this pathetic line:
"Can't you just let us borrow your IT guy to fix a few minor issues that I'm sure won't take 5 minutes? We shouldn't have to pay $90 or more an hour for what we are sure are minor issues."
Of course, once I get over there and walk in I see that the place is an absolute disaster and it takes me all day (or more than one day) to fix everything and that client just got hours of my labor for free. And the best part is the phone call I get the next day where they forgot to mention one of the problems they had and could I come back real quick to fix that, too.
VMWare appliances would be great for these guys but you have to convince them to buy it. And that's hard as VMWare does cost a little bit of money.
I'm not sure what to do or if anything can be done at all about this situation. We have an entire category of people - the ones we are trusting our health to - that are totally IT averse. The government is trying to force them to adopt more electronic practices with HIPAA, meaningful use, incentives to buy an EMR, etc. But the resistance I'm seeing is unreal.
Why do these guys hate and mistreat their IT infrastructure so much?
James,
There's obviously two issues:
The Client Desktop could become a simple Ubuntu appliance that can be reloaded periodically for a particular user. Provided you managed synchronizing browser bookmarks (such as Foxmarks), and used cloud-based office document storage (such as Google Apps) there's not much else that's really needed on that client desktop. Of course, I'm presuming the EMR is an install that supports Linux OR that its a Web-based client.
Is the Office Server actually doing anything? Our beast of a Dell Office Server generates lots of noise, heat and has become a quite expensive VMWare host and SourceSafe library. I would certainly run most VMWare OS from portable USB drives, while there's plenty of free or cheap online storage. Suspect we'll be retiring our server at the first sign of it needing maintenance.
So, that's my answer - Kill Bill - remove Microsoft Windows from the desktop. Install a tight locked-down Ubuntu desktop and overnight most problems have disappeared!