NOSH ChartingSystem

A new open source health charting system for doctors.

Dominoes and Data

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From my last post, I spoke about the power of data…who it belongs to and the power that it wields based on who owns it.  A couple new developments in the Health IT world have got me wondering where this is all going (and unfortunately confirming some of my concerns I addressed in my last post).

1.  A “free” EHR company, Mitochon, has bit the dust.  Not only are doctors who use the service in the lurch, but they are not the only casualty.  Mitochon is one of many “smaller” vendors that have fallen like dominoes (either shut down, acquired by a larger EHR entity, or both) since Meaningful Use began.  We are now in the consolidating and monopolizing phase of this grand crony capitalism experiment.  Along with monopolization, we are now seeing data ownership (as well as profits) increasingly belong to a small elite of corporations.

2.  Along with consolidated data ownership, there are now observations in the field that data mining will go full steam ahead.  From Chandresh Shah’s blog,

To me, it is clear – there is something else cooking. That stew is ‘data mining’. For sure, I am not talking about selling patient data, but analyzing aggregate intelligence, which is in dire need by Pharma. Today I believe Practice fusion EMR company is building the mass and momentum. This is why they have billionaires like Peter Theil behind them. They need lots of cash to burn every day.

If you have concerns about patient data privacy and unmanageable health care costs, this comment should raise a few goosebumps.  The future of health IT may look enticing for those that have the “in” right now, but will be a disaster for health care providers and patients in my honest opinion.

3.  Deloitte put out an executive summary based on a survey of 610 physicians regarding health IT adoption.  One of its findings showed that more than 1/2 of the current non-adopters of EHR’s have no current plans to implement one at all.  Furthermore, it states that most physicians do not use mobile health technologies in their clinical practice, and most are slow to adopt online tools and health technologies in direct patient care.  I see this as a further proof that there is clearly a “digital divide” now and with the way Meaningful Use is heading, those physicians that are left behind will be truly left behind.  What’s going to happen after that?  After all 2015 is coming up pretty soon….

The future can be changed if we start here.

There are alternatives, with open source projects leading the way for offering realistic and reasonable models for data security/privacy, cost of implementation, and decentralization of data with my project being one of them.  My vision for real health-informed information technology is for a focus on a user-centric interface, low-cost of use and ownership, and an open standard for exchange of information, NOT monopolization of services and data aggregation to be used for marketing, which only raises health care costs for everyone with questionable improvement in health care for all.


On the issues of the effects of health care costs due to the ridiculously expensive installation and ongoing maintencne of EHR’s (Epic in particular), I’m pointing at these two blog posts involving Wake Forest Baptist Hospital, and Maine Medical Center…both hospitals are now struggling financially and announcing budget cuts because they have implemented Epic, the money pit.  Imagine that this is happening to large-scale hospitals across the nation, and then imagine what this is doing to small physician-owned practices!  It’s a sad affair when health care access and quality care is being compromised by technology and greed.  What a waste.

Author: shihjay

I am a family physician and previous medical director for a child abuse assessment center. I am now promoting my new electronic health record system (NOSH ChartingSystem) that I have developed and used for myself in my private practice since 2010 and now I want to share it to the rest of the doctoring world.

One thought on “Dominoes and Data

  1. I agree with many of your observations. A practice management and EHR software should represent a business investment that a doctor makes in his practice that serves a purpose and pays for itself. Nothing is FREE. Doctors who provide data about themselves and their patients for sale after having been the patients de-identified (but not the doctor) should not surprised at the future COST to them and their business.

    I have been in this business for nearly 30 years, and I have always been able to say that the return my customers have received on the fairly priced investment that they make in our product and our services for use in their office is significantly greater than the initial and ongoing investment. The recurring revenue that MacPractice receives from its clients is what assures the clients that we are able to continually upgrade and support their software and their practice’s use of it….that and the fact that our company is not directed by any investors, nor is it publicly traded.

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