Musings of a Dinosaur

A Family Doctor in solo private practice; I may be going the way of the dinosaur, but I'm not dead yet.

Saturday, April 14, 2007

EMRs: Let's Really Dream

Dr. Bob has posted a Love Letter to the VA. After his quote, he adds this:

So why does the rest of the country not adopt the VA EMR? Interestingly, this is the only EMR designed for patient care, rather than for billing. Hospital administrators want billing systems. The VA system was designed for health care professionals, not accountants.

I wish the entire country had a common EMR.
So why doesn't the federal government make the software available for free to all licensed health care providers? Not access to the VA's database, but the system itself. We've already paid for it with our taxes. Seems to me it would be the fastest, most efficient way to usher in that era of a universally accessible, portable EMR that DB and the Bush administration claim to want.

Nah; too much money to be made keeping it fragmented among dozens of vendors and systems that need periodic updates.

(Coincidentally, post coming soon: Why an EMR is Not Right For Me)

5 Comments:

At Sat Apr 14, 05:01:00 PM, Blogger Rebecca said...

Vista IS free and in the public domain. I don't know how easy it is to implement and get started using, but it is available.

 
At Sat Apr 14, 10:00:00 PM, Anonymous Anonymous said...

Anyone who truly know: care to post a link to the public domain that is Vista?
Thanks.

 
At Sun Apr 15, 01:51:00 AM, Blogger Dan R. said...

The source code is available at http://www.hardhats.org/, as well as other distributions that try to make it easier.

The problem is that the system is built on such antiquated technology that only VA systems engineers have any idea how to implement it.

 
At Sun Apr 15, 10:39:00 PM, Anonymous RJS said...

While VistA is technically "free" -- it's really not. Until some hackers get ahold of the code and start distributing binaries useful for other non-hackers, VistA will remain, essentially, a system not available for public consumption.

Unfortunately, the number of hackers who also have a great deal of experience with the day-to-day operations of private practice are very, very few.

I suspect that high barriers to entry on both sides of the fence will perpetuate this issue until such time as an interested party (maybe) finds a way to streamline VistA and profit from selling it to relatively small, private practices and the like. In the meantime, I suspect NEPSI will become the defacto standard, if anything does.

(And I honestly have no idea if NEPSI is a full-fledged EMR, or merely an e-prescribing system. I think it's only the latter.)

 
At Wed Apr 18, 09:37:00 PM, Anonymous Anonymous said...

Just as you can't get more than one doctor in a room with the same opinion, you can't get a unified EMR. We all want the EMR tailored to "us". So something has to give. Either we have Big Brother ram one unified EMR down our throats, or we accept 600,000+ versions of EMR (or however many doctors there are practicing in this country).

Someone told me once that opinions are like assholes, everybody has one (or a modified version of one in the case of colostomies)

 

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