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Hitting the EHR Wall — The Interoperability Challenge

May 8, 2008
by Pete Rivera
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It was the perfect convergence in time; we got through the expenses of Y2K only to take on HIPAA requirements and then we had the Stark changes. Combine this with lower hardware costs and you have a perfect opportunity for all the late adopters to jump on the EHR train, or at least that’s what everyone thought. There just isn’t a big push to install EHR’s across the industry. It is almost like the industry is waiting for a product to come along and offer a “Doc in the Box” solution that is plug_and_play. We want a Windows EHR, with all the associated products that is intuitive, we plug it into the USB port and Windows tells us that it has installed all the drivers and is ready to go.

The good news is that most Ambulatory EHR’s will offer a solution right out of the box. Import your demographics and start seeing patients. But wait! Without my labs I still have to print and file, so what good is it? Oh, and my radiology, MRI, and other diagnostic referral results would also have to be printed and filed. That’s just duplicating effort, and I just don’t have the time. You mean I have to type, use the mouse and talk to the patient at the same time? This creates a wall between the doctor/patient relationships. So is there really a solution out of the box? We can not crawl before we walk anymore, we need everything to operate together seamlessly right out of the gate.

We really have created a high expectation of what an EHR is suppose to be and what replaces the paper chart. Can an EHR coexist with a paper chart during a transition phase? Do we now have to provide all or nothing? The process of integrating legacy systems to interoperate with EHR’s is challenging, but not impossible. I would think that by now everyone has made a business case or a clinical strategy to embrace an EHR within the next 5 years, or have we really hit a wall?

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