Tuesday, May 12, 2009

CCHIT: Docs, What Matters to You?

Few credible articles begin with sweeping generalizations, but here I go (again): Doctors are acting as mere bystanders while regulatory groups -- for whom physician's needs are not paramount -- decide the future of electronic medical records. And the world. (How's that for sweeping?)

But, seriously, here's what's been going on: Docs receive pronouncements from the government, or other organizations like CCHIT, that will not only determine the fate of health care IT, but which will radically influence their day-to-day lives as medical practitioners. In the meantime, there's a lot of fretting, twitching, Googling, and conjecturing about what is to come. It's an insidious kind of self-disenfranchisement: doctors proactively (and rightfully) strain to listen to the cacophony of voices that have something to say about EMR, but are then reluctant to disagree with what they're hearing. And most of the time these voices do not address or accommodate the specific needs of ophthalmologists -- the ones who will actually have to come in contact with the new technology.

Docs, it's time to take matters into your own hands!

Okay, so I work for an EMR company. If you're a doc, there are probably some trust issues here. But, in all seriousness, it's become apparent to my colleagues and me that, without fail, the issues that concern doctors about electronic health records do not align with the issues prioritized by the higher ups.

And why should they? Apples and oranges, folks. Doctors want an EMR that will work for them: something that is fast, usable and will not compromise their work flow or productivity. In turn, EMR vendors are working to develop products that will respond, specifically, to these challenges.

The government, on the other hand, presumes the blanket success of the EMR industry to be a foregone conclusion. As such, health care higher-ups have preemptively -- and prematurely -- devoted their efforts to the regulation and proliferation of the industry.

But -- what industry? C'mon.

Consider CCHIT-certification. Nearly all stipulated criteria thus far have revolved around issues external to individual practices -- issues like auditing or interconnectivity. There's nothing inherently bad about tackling these issues, but it's a total cart-before-the-horse scenario. The timeline has been curiously inverted, such that less-pressing issues garner precedence over other measures that would ensure usability.

Take, for instance, the requirement that EMRs support DICOM images. Fine. It's something that, if uniformly adopted, would foster standardization and, eventually, interconnectivity. The problem is: almost no (or at least, very few) ophthlamic machines create DICOM images. There's no so-called "community network" to move these images around in. So why, then, make this a pressing issue for 2009?

The need for more doctor involvement in the regulation of EMR is clear. How can you get the ball rolling? Write to ASCRS. Write to AAO. It's at least a start. Make sure that your interests are being met. Create pressure so that the issues that matter in the exam room (speed, interoperability with practice management systems, etc.) are prioritized.

EMR is still in its infancy. In order to serve doctors and to succeed as an industry, we should be most concerned with enhancing and streamlining actual usage. Of course, IO Practiceware believes deeply in the importance of interconnectivity with other practices -- but it should be Stage 2, as opposed to Stage 1, of the CCHIT certification process.

Stage 1: Let's make it happen.


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  1. I resent the fact that you think doctors are unable to rally themselves in the cause of EMR! They know what's up, they are just busy.

  2. Dr. Tristan StrongMay 27, 2009 at 11:17 AM

    Over and out. I hear you loud and clear. "Anonymous" stop vilifying doctors. We're on the frontlines every single day. We don't need criticism.