05 Aug #FAIL! Proprietary EHR LockIn through CCHIT Certification
* I just found several blog posts that I had written but never posted. Sorry that these are late but there are still worthy of a link or two.
I just saw some serious lame legislation proposed out of New Jersey by some ill-informed congressional lackey legislating that all EHR’s be certified through CCHIT. This is absolutely ridiculous. Do you really want to outlaw Google Health and Microsoft HealthVault in the Garden State? I mean get real!
* CCHIT later published some comments about this
The unintended consequences of such legislation is highly problematic and well described by David Kibbe, Fred Trotter, Ignacious Valdez and others. I have seen CCHIT make great efforts to correct this and make the process more open but they have a fundamentally flawed and constrictive position – that they alone can bestow the quality seal of approval on software.
They don’t realize, of course, that any attempt to subvert innovation will be futile. “Life (or in this case innovation) always finds a way”. The notion of a new type of communication platform that will emerge as a result is already underway. Designated “Groupware” by David Kibbe or a new “Communication” platform by Myca or American Well, new tools will continue to emerge that defy current descriptions. Are you sure you want to lock down into today’s technologies through an already arcane certification process?
I would strongly argue that standardizing features and functionality is not the problem. These should be allowed to freely evolve and grow per the needs of users and the skills of developers. What should be standardized is the interoperability requirements of data, the database requirements, and related infrastructure elements that will enable the data to be truly liberated. These standards will do more for the industry than any other single legislative or policy initiative. This is where we need government help to force agreement on specific principles where the choice is not as consequential as just making a decision (driving on left or right side of the road is irrelevant; but it is clear that we need to make the determination!).
Legislative mandates for features and functions = #FAIL!
Natalie Hodge MD FAAP
Posted at 19:43h, 12 AugustHi Scott, your blog is hilarious, and I share your feelings about CCHIT, coming from one physician beaten up by an HMO dominated market to another, like you, I tired of talking about problems a few years ago to focus on solutions, and we have come up with a couple of good ones which marry health 2.0, transparency, entrepeneurship for MD’s , integrated PHR/EMR of course, rolled up with a little social media and ecommerce, and of course house calls, the only TRUE patient centric practice.
Natalie Hodge MD FAAP
Clay
Posted at 19:26h, 06 AprilBravo! Well stated! The pnesert state of the EMR is such that even in the hands of the most computer savy physician, he or she spends more time with the computer than the patient. Last time I looked we were treating patients, not computers. There seems to be a misconception that anything done by computer is faster and better. Sorry, last time I checked, human emotions, symptoms, and complaints are not a linear function. In the near future it appears the government will be giving a 5% penalty to those physicians who treat Medicare patients and don’t use an approved EMR. This is laughable in that physician productivity probably drops by at least 20%, i.e., seeing 20% less patients per day. It doesn’t take Quantum Mechanics to do the math here. Then, again, this may simply be consistent with federal deficit thinking. Another consideration is that when physicians, either by force or choice, spend less time than needed with a patient, they tend to order more tests to make up for what is lacking in the history or physical exam. We all know what that does to medical costs. Yes, physician productivity must be addressed! By the way, have you ever ventured a pronunciation of CCHIT. Perhaps there is some subliminal message here.
Dani Galletta
Posted at 12:40h, 30 JuneExtremely curious blog blurb.