I read this and I had to comment as the way experience developers know their product and code versus a survey or user will never be the same. These are observations made from the user side and some are valid, but again some of the statements made are just due to lack of education on how writing and getting to market works.  The statement where the vendors have been pre-occupied with back logged implementations…duh…you have to be because software builds on itself and there are elements that have to be completed before you go off in yet another direction. 

The outside person has no clue on the structure and this struck me as a bit of a novice comment here too with the “unmet” pleases for interfaces.  I spent, hours, days, weeks, etc. on user interfaces working with doctors, it’s team work here. Pacing with accountable care programs…there’s another one as this is new in practice and there can be many IT infrastructures applied to a concept or model.  I have yet to see a mathematical model for some of this, that is if they are planning to stretch out into some non linear areas.  I will say this and I have said it many times the vendors did miss the boat with common user interfaces as all wanted to sell the better mouse trap.
Doctors love to learn more than one EHR system…NOT.  Many people on the web commented on how the interfaces of the system changed direction to accommodate the payers over the last two years, and I think there’s some merit to that.  The link below has some history and some interesting information. 

EHR Vendors to Focus on Usability? What a Surprise, Many Systems Have Done This For Years, EHR Systems Owned By Insurers Though Might Be Subject to Different Flavors and Goals


A couple years ago I was talking on Twitter with a few folks that said we needed a common user interface and I pointed them to the link below, there was one which is open source to work with but nobody bit and again the payer influence here could have had something to do with it. 

EHRs need Standard Templates – So Let’s Look at the Common User Interface Project, a lot of the work is already in progress and partially completed


Very few realize the time and complexity that has developed over the last few years either as just as you might be close to a release you get a left curve with something new that hit the market and decide it’s critical and hold off, which is a good thing for better code and working program.  You might find some errors you need to fix at the last minute.  Goodness sakes, how many times has Microsoft delayed putting out an operating system, happens to everyone.  I’ll say it again with the link to a former post, time.  What’s the next step chaining developers to computers and whipping the code out of them:)  I know even HHS doesn’t get the time element as they want every one to hurry up, good luck:)

Speed Up Rate of Change in Health IT?–“Short Order Code Kitchen Burned Down a Few Years Ago and There Was No Fire Sale”..IT Infrastructure Chance and Revisions Takes a Lot of ”Code”, “Time” and “ Most Importantly Money”


“I’m sure the CIOs out there just sigh too when articles as such come out, again they probably share the same impression, will someone get a clue on how this stuff doesn’t happen in the time frame you want:)  This whole readmissions issue with looking for “magic algorithms” is yet another issue.  Sure analytics help but they are not the 100% answer.” 

Sure all EHR systems have issues just like all operating systems on computers, so this is not Burger King where you get it 100% your way.  Again most vendors work hard to please clients and listen.  I used to get that on the interfaces too as a developer your do parameters to work within two so a lot of negotiation and work back and forth as maybe I could get exactly what they wanted but could come real close. Eat dog food as a developer too, as all my ideas on the user interface were not winners either, so again two sides working together. 

As far as meeting needs, many have specialist versions or templates and basically you can make a general EHR work for you but it may not have “everything” you want.  I’ve seen it out there.  It also depends on how much money is to be spent too.  As far as not meeting needs, technology had something to do there as well, we keep forgetting things change so quickly. 

On mergers and acquisitions, that’s an area of concern as we had Allscripts who said their integration would be ready by a certain date, kiss of death as again you had a non tech CEO trying to put a huge integration on a schedule and you have to allow for more time.  Whatever your estimated time element is at least double it.  Again it is not all the vendors here as you will find most of them have ongoing development departments and allow doctors to test revisions fully too if they want to be a beta office. 

Doctors Have Become One of the Largest Software Beta Testing Groups–”Magpie Healthcare” Unfortunately Still Thrives


It’s also worth a mention to look at the EHR  and has it all been developed in house or did it go through a series of integrations?  That is huge with one company doing it from start to finish as they have all their code in house and is probably why companies like Epic these days can call their price.  Remember Judy the CEO of Epic also wrote code and big difference there too with commitment and knowledge and someone said the other day, don’t start any technology company if you are not some type of technologist yourself.  Many companies now are offering free data base transfers if you switch to their software which a good thing. 

In summary this is the nature of the beast with EHRs as it’s a moving target and thing started to speed up tremendously with Health IT a few years ago and that is what it is.  Nobody to fault for that at all.  If you need help choosing a system, use the advertiser links on the left of my site as EHRScope can help you or there are many other resources to look at. 

They are a sponsor of the Quack so it makes sense I include them as a resource as that’s what they do. If you are waiting for a perfect EHR in this fast paced world of Health IT, dream on and it beats the heck out of paper charts any day.  BD



The independent insight gathered indicates that many EHR vendors have been preoccupied with backlogged implementations and selling product that development issues have been neglected as a priority. Most concerning to current EHR users are unmet pleas for sophisticated interfaces with other practice programs, complex connectivity and networking schemes, pacing with accountable care progresses and the rapid EHR adoption of mobile devices, the survey finds.  
http://www.healthcareitnews.com/news/ehr-users-dissatisfied-consider-switch

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