Before designing any new healthcare administration, passing it and signing it into law, force EMR companies to bid and display their wares. I co-own and run some medical practices in the state of Virginia, and I am appalled by what I am hearing from official Washington and the media about what quality, secure and reliable EMR systems will costs. I have heard costs ranging from 40,000.00 per medical office up to 20 million dollars for hospitals.
I can tell you from experience that some of these EMR companies are taking advantage of physicians ignorance. I have had some come in my office and tell me that to set up a "state of the art" system" would cost us 50k. I told them to hit the door. We purchased a system for our offices for under 12k and that includes outfiting 2 offices with computers as well as the software.
There are EMR companies that are owned and run by physicians. The biggest complaint other than the outrageous costs being thrwon around, is that most of the EMR software is written by engineers that think like engineers. So when I doctor goes to use it, it actually decreases his efficiency as he struggles to write a simple note, or prescription. I've found that the more expensive the system, the more complex it is and the bigger waste of money it is.
Talk to all EMR vendors, large and small. Don't discount the small guys just because they don't have slick websites and glossy brochures. Make sure the Docs on whatever advisory panel you have, are not on the take either. Most doctors are honest hardworking people, but most are not great business people. So they will buy whatever some silver tongued salesman has to sell without doing their due diligence.
It should NOT cost the average practice 40k to have a great system. It should NOT cost a hospital 20 million dollars to upgrade to EMR. (For 20 million dollare one could build a state of the art cardiology wing or a cancer research institue that would make NASA jealous!!)
Again, if you don't have anyone that can tell you the flat footed truth, email me back I'd be glad to come in and help make sure that Physicians and Hospitals and ultimately the patients and taxpayers don't get screwed!!!!
Comments (4)
Bigger Picture
Another vitally important characteristic for any software is a standard communication component that allows communication with other systems!!!!!
In addition to EMR, as a patient and an RN, I would liketo see the ability of communicating directly with the physician or nurse practioner using email or something like Skype being put into use rather than having to go through several layers of medical assistants, who are needed in the office situation, yet are often horrible at communicating what a patient has said are the problems or needs he or she is calling about. These MA are well meaning, but don't have the background to be able to distinguish what should be given to the healthcare giver and often the patients end up having to go to the office for a visit when it could have been handled with a direct communication to the healthcare giver.
I would hope that through transparent review of the possibilities and further public awareness that Government support to all humanity for access to affordable wireless communications and associated imbedded applications becomes accelerated into an immediate reality. Ideas of energy conservation and modernizing how we communicate information on a global scale become apparent with a brief analysis of current abilities using satellites and wireless communications devices. We should be extraordinarily supporting the transition to this communication style as it is the most cost effective way to upgrade humanity into the 21st century.
How does everyone feel about creating an open source EMR project (or projects)? VistA is a good start, but the technology and language (Mumps) is specialized and not used by most developers. I know of a few open source projects, but there are some regulatory hurdles that cause some issues (see HIPAA below).
As Donna pointed out there are technologies that could be used (Skype, or similar) to enable direct communications between the care giver and the care receiver.
An open source project would lower costs (not to zero), and would provide better interoperability. I developed an EMR system for a mid size clinic (50,000+ patients), so I've seen what it takes.
It would also be beneficial if HIPAA could be amended to allow records to be stored off site and accessed securely. Currently HIPAA has requirements about physical security that make it difficult to store records this way. Many small providers should not need to incur the cost of an IT system in order to have the benefits of EMR.