NOSH ChartingSystem

A new open source health charting system for doctors.

EHR Misery Loves Company

3 Comments

It seems like there’s been news after news of bad, certified, EHR implementations and experiences lately.  Is this what Meaningful Use was supposed to be about?  It’s as if the chickens have come home to roost. 

In her post (http://getbetterhealth.com/more-unintended-consequences-of-digital-data-how-an-emr-gave-my-patient-syphilis/2013.08.22), Dr. Val Jones speaks about her experiences as a locum tenens and working at various different hospitals, with most of them with seemingly horrendous EHR implementations.  One of her examples is when a hospital has to use medical transcriptionists in India to input data back into the EHR and physicians having to proofread them.   The other is an example of a hospital IT department taking up whole wing of a hospital that manages the EHR to keep it from crashing daily (!!!) and sending frequent public announcements to warn staff of a pending crash (!!!!!!).  Sounds like a skit straight out of Monty Python.

In a different article, Sutter Health in California had a EHR blackout when their Epic system went down in “epic” fashion, rendering it useless for nearly 8 hours in some facilities.  (http://ehrintelligence.com/2013/08/28/sutter-clinicians-deal-with-unplanned-downtime-with-epic-ehr/).

And more data for ransom news…physicians at Milwaukie Health Services in Wisconsin were unable to access their patient data when their contract with their EHR vendor ended.  And to top it off, this vendor requested $300,000 from them to get their data back. (http://www.jsonline.com/business/community-health-center-battles-for-patients-records-b9957634z1-216291331.html)

But seriously, this is crazy stuff when there is already fairly good “mission-critical” setups in the non-medical world (ie financial, consumer goods transactions).  What is going on here?   Is health IT really that incompetent?

I get why physicians want to go back to the good old days of paper and pens and trash the digital data.   The amount of money spent by our tax dollars to fund these expensive and out-dated (and possibly unsafe) EHR’s to medical professionals should anger both patients and physicians.  And to whose benefit?

The truth is, digital data is going the be the future.  We are in the age of smartphones, tablets, and the Internet.  Technology in every sector of our lives is advancing exponentially and it isn’t going to stop.  Medicine is already far behind the curve on this one and it needs to catch up.  But the critical point, that I’ve made before, is who should be in charge of the data?  Who should have the absolute say in the way data should be entered so that we get quality data that helps our patients, and not  the pockets of administrators, insurance companies, and EHR vendors?  Physicians had been effectively left out of the loop when it comes to EHR design and safety considerations., and now we see the result of these costly decisions.  If we (patients and physicians) tell our Congress to take the toxic financial incentives away and allow physicians to embrace digital in an organic and non-punitive fashion, we can hopefully make that transition without leaving casualties such as the examples I’ve highlighted above. 

Don’t forget…please spread the word about my Indiegogo campaign at http://www.indiegogo.com/projects/nosh-chartingsystem-a-new-open-source-medical-record.  Let’s make a start to overthrow the era of bad EHR’s.  It starts here and now.

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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.

3 thoughts on “EHR Misery Loves Company

  1. I’m in agreement on open source software. My wife is just starting to practice and is working with her dad in an existing paper-based practice. I am a former Cerner employee and have been looking for options for them. I was settling in on open-emr.org and remit.org for billing. The Dev group at openEMR seems active and they currently integrate with Newcorp and the free and paid versions of Allscripts through a Javascript. My question, have you looked at that option and if so do you think your approach is better? How?

    • Randy, I have indeed looked at the options OpenEMR has. Before I made NOSH, I was attempting to make OpenEMR more user friendly but it was too much that I had to re-code and overhaul, so I decided to start over. Out of the box, there is not full integration with ePrescribing with OpenEMR. For NewCrop, you have to use a specialized version of OpenEMR (see their wiki). For Allscripts (free), you have to install Greasemonkey with scripting done client side. With my testing, it was flaky. NOSH integration is with DrFirst rCopia. The code is complete and workable. I have one client that is registered but I could not release it to others because of this licensing issue which I’m gathering funds on Indiegogo to be able to use it. If the funding goes through, then I can announce that my EMR can fully integrate with rCopia which is seamless, runs in the background, with minimal user double entry. That is why I think this method is better.

  2. There’s a lot of effort being made by good people each of which seems to have a piece of the problem addressed. I like openEHR’s approach of using archetypes to define data. The problem many vendors have is using site defined data type causing incompatibility for clients using the same software. FreeMed’s billing software is better than nothing. FreeShim is a decent way to interface equipment. OpenEMR has a patient portal and an OK user interface. Does a good job of being cross-platform compatible and is trying to address HIT meaningful use, although Newcorp hyjacked the app when they built the interface and got that used for 2011 edition certification. They charge $30+ per month. Is DrFirst rCopia in the same ballpark?

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