FWIW, this is pretty much exactly what we do @ <a href="http://elationemr.com" rel="nofollow">http://elationemr.com</a><p>I understand the cynicism in a lot of the comments here about it being impossible to compete against existing juggernaut systems, ridiculous 500k servers for small group practices, and even the bits about nobody caring enough to fix it.<p>I've been in Health IT for something like a dozen years, and it's true that it can be a serious pain in the ass. At Elation I think we're doing the right things to turn the tide. We're selling a really amazing clinically focused EMR system to physicians (not to their C-level hospital administrators), and so far they love it.<p>There's a ton to do and we're a tiny team. If this problem resonates with you please do get in touch. It's easy to find folks that want to work on dropbox or the next YC Airbnb-for-X but not as trivial to find folks thrlled (or crazy enough?) to tackle the mission we're on. My contact information is in my profile.<p>Apologies for the plug, seemed appropriate enough to be warranted.
GUI and visualization tools seem to be an afterthought for the big EHR vendors. Peeling the surface layers off of EHR systems, it seems they are essentially big ERP systems with a medical bent. So they require multitudes of system-building consultants, nine figure purchase prices, and a bigger focus on making sure billing/procedure auditing can be done by administrators than facilitating MD/patient dataflow.<p>FTA: "why wasn’t the EHR already doing the legwork, displaying these potentially pertinent correlations and data points, painting a more descriptive clinical picture, instead of leaving me to wade through mounds of information?"<p>Because the focus of the EHR system is about billing and tracking medical record treatment for hospital administrators (auditing) rather than enhancing clinical treatment and understanding for MDs?<p>Probably a large opportunity here to do cool and better GUI and visualization, but good luck getting past the EHR vendor guard dogs to even read-only access the back-end data.
I completely agree. I work with several of these, and I'd really like to help make them better.<p>There's no reason why an EHR used by 100 employees needs a $500K Dell server to run, doesn't support load balancing (but needs it, since the app can't handle more than 40 users, so you need a bunch of VMs on that server) and uses up hundreds of gigs in the database (wikipedia is like, what, 50gb uncompressed...?)<p>They suck, there's a market.
I'm a physician. While musing about clinical reasoning based on robust tools like Kanren and miniKanren, I wrote a few thoughts that parallel the article:<p>"Much if not all of the current talk around clinical software unfortunately stops at electronic health records (EHR) – the paper chart (with all its limitations) mirrored in various incarnations of ‘the cloud’ (with the additional disadvantage of confidentiality rot). For all the endless effort put into EHR, it was a problem solved long ago with nothing more than punched-card-fed mainframes. All we are seeing now is the iterative pursuit of competing data interchange platforms."<p>"Physicians and researchers need software that advances the goal of making routine things routine beyond just the level of data storage and retrieval…<i>to decision support, data discovery and visualization, unsupervised ontology construction, and scripting of reasoning agents."</i><p><a href="http://apps.keithflower.org/?p=238" rel="nofollow">http://apps.keithflower.org/?p=238</a>
Would it be easy to sell a more advance EHR to hospitals if you could show it would cut down on malpractice? Sounds like all the comments are saying penetrating the hospital market has huge barriers. But if this is obviously better, and could save time & lives, they should use it.
forget design, from what I've seen of these systems, physicians would be happy to have a system that doesn't require them to log in 4 times in some rube goldberg contraption of a VNC in order to actually open the medical record...
This is a common complaint amongst doctors. I'm not exactly sure how a call for design can really work. How can a future startup compete with these juggernaut EHR systems on design alone?
tl,dr:<p>Better design will save lives, and EHR sucks.<p>1 is true, 2 is true but nobody cares enough to fix it.<p>You cannot begin to imagine the amount of fuckheadedry on parade in any hospital by the combined egos and efforts of doctors, administrators, and computer janitors.