The Electronic Health Records and HIT Professionals Network
The Ethical Dilemma of the EMR World
Ethics and professionalism are bywords that are not taken lightly by the medical care professions. That kind of allegiance is expected. It is ingrained early on by training and by work experience.
The EMR market, a child of the world of technology but joined at the hip to medicine, has brought together two different views or connotations of ethics and professionalism. On the one hand the technology vendor plays in the rough and tumble world of high technology where the mantra is to sell anything at any cost because the customer won't know what they've bought.
On the other hand, the generally technically naive medical world is unprepared for this kind of interaction. Oh yes, they fight with insurance plans and hospital administrators. But in no way does that prepare the medical world for the business and sales tactics of high technology vendors.
To solve this dilemma, either by design or by accident, vendors have incorporated a Chief Medical Officer (CMO) whose role is to bridge the perception gap between vendor and medical customer. With a medical background and a medical persona, concerns between the vendor and medical customer are allayed.
But medical angst persists. Because the EMR vendor is pursuing a "top down" sell, they bypass the medical leadership and pitch the C-level administrative staff. The medical input is usually an afterthought and the medical angst continues.
Countering the medical angst and overcoming the perception of "business ethics" being ugly will not be easy. If there be a truth in medicine, it is the gaining and loss of trust. Trust is not a trivial matter that can be bandied about just for a sale. To belie the image of the untrustworthy EMR vendor, both vendors and medical professional must make this their primary goal and objective even before the first sales pitch is given. The reward is either an EMR project that is successful after two years or an unsuccessful project that lasted ten years. The shipwrecks of EMR failed projects are a testament to that result should we forget this difference in world perceptions.
The EMR market, a child of the world of technology but joined at the hip to medicine, has brought together two different views or connotations of ethics and professionalism. On the one hand the technology vendor plays in the rough and tumble world of high technology where the mantra is to sell anything at any cost because the customer won't know what they've bought.
On the other hand, the generally technically naive medical world is unprepared for this kind of interaction. Oh yes, they fight with insurance plans and hospital administrators. But in no way does that prepare the medical world for the business and sales tactics of high technology vendors.
To solve this dilemma, either by design or by accident, vendors have incorporated a Chief Medical Officer (CMO) whose role is to bridge the perception gap between vendor and medical customer. With a medical background and a medical persona, concerns between the vendor and medical customer are allayed.
But medical angst persists. Because the EMR vendor is pursuing a "top down" sell, they bypass the medical leadership and pitch the C-level administrative staff. The medical input is usually an afterthought and the medical angst continues.
Countering the medical angst and overcoming the perception of "business ethics" being ugly will not be easy. If there be a truth in medicine, it is the gaining and loss of trust. Trust is not a trivial matter that can be bandied about just for a sale. To belie the image of the untrustworthy EMR vendor, both vendors and medical professional must make this their primary goal and objective even before the first sales pitch is given. The reward is either an EMR project that is successful after two years or an unsuccessful project that lasted ten years. The shipwrecks of EMR failed projects are a testament to that result should we forget this difference in world perceptions.
Comment
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Comment by natalie hodge on April 10, 2010 at 4:12pm
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Wow richard, I'm just a lowly doctor that makes house calls, reading your post which is certainly targeted for execs- wearing- armani- suit- and -shiny- suit -types, makes me so sad, for us on the front lines of patient care. Here is where I am coming from. I have indeed utilized many of these systems over a five year period myself. Each one making incremental improvements, yet, missing the mark on so many levels. The sheer fact that the suits are selling the suits here explains quite a bit in the inferiority of HIT out there. There is a nice study which points out the barriers that patients feel when their doc is charting with a laptop during the visit. Here is the newsflash, physicians are utilizing crappy systems for the most part. You said it yourself, " The medical input is an afterthought!!" It is up to doc's to take control of their destinies and move forward with not incremental change, but disruptive change, this provides massive improvements for patients as a lovely byproduct, housecalls. The only way to have a user friendly product is to have rapid user iteration, that is physicians iterating DIRECTLY with developers. That is how we are approaching our Ecommerce/EMR/PHR/ virtual office practice platform.
Here is a presentation that details how this all came about and offers a disruptive solution for the future providing cost reductions of 80%... Please share it with your friends who are passionate about innovation...
http://www.slideshare.net/nataliehodge/natalie-hodge-md-faap-innova...
In which zip code do you live?? i hope you will take the opportunity to go to
http://personalmedicine.com/pmi/
and sign up for your free PHR today, or upload your doc's from microsoft or google directly. I will have a house call to your doorstep by next quarter in something like this...http://personalmedicine.com/pmi/images/stories/logos/01_volvo_pm_lo...
And I also invite the c-suite to hear me Panel Next month at ICSI.org's innovation Symposium, to learn how to add a 50 million dollar service line to your five year strategic plan. Your ship is sinking... you don't want to go down with it....
Natalie Hodge MD FAAP
www.personalmedicine.com
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