I have been monitoring and watching the EMR market for the past 15 years and over that time I have developed a sense of what it takes to develop a great EMR system. These are my personal opinions and I would be interested in your thoughts if you are either a user of an EMR, a physician who has developed their own EMR or a vendor of an EMR product.
Developing an EMR is not simply about the technology - in my opinion, that is the easier part of the process. Here is my short list of what is required to develop a great EMR system:
- Core universally accepted standards that provide a dependable foundation upon which to develop the EMR. These core standards must be backwards compatible if they evolve over time. (This is akin to building a railway train and knowing exactly the gauge of the tracks, allowable physical dimensions and weight restrictions);
- A set of functional requirements that match the needs of the users. This requires a very clear understanding of the business and clinical processes that the EMR must accommodate. For example, if the daily work pattern of a GP entails writing prescriptions, exchanging information with colleagues, capturing clinical notes, receiving and requesting lab investigations (to name a few), then the system must be able to incorporate all of these functions;
- An ability to evolve the EMR system over time with a robust process for user feedback and product enhancement. It is my view that developing a highly usable EMR requires multiple cycles of feedback and enhancement before usability is slick enough to meet the needs of the majority of physicians. How many cycles of feedback does this take per feature - I am not sure, so would appreciate your feedback, but I think it is many!
- A stable development team. Architecting an EMR is a long-term process. If the technical platform upon which the EMR is based does not have the benefit of core developers who maintain the vision and integrity of the design, then overall stability and sustainability of the EMR can be severely compromised;
- The right value proposition: If the value proposition is not clear to the end-user, such as: Increased revenue/savings, the ability to work remotely, better information about patients, improved workflow processes, easier and more complete report generation and improved decision making, they will not adopt and use the systems;
- An acceptance that the EMR is not going to be perfect out-of-the-gate. The establishment of reasonable user expectations is key. However, the system should encompass the fundamental business needs from day one. (If you were a small business owner and a sales representative was trying to sell you a point-of-sale cash register that allowed you to make change, but required you to write the transactions down manually on a roll of paper - would you buy it? I doubt it.)
Comments