As promised, this is the first in a multipart series, about the innovation going on in the Electronic Health Record space. This isn’t meant to be a comprehensive review of all the EHR vendors out there. It’s a short list of a few of the EHRs that have caught my attention for being innovative or exciting. Those EHRs that make it easy and free to sign up I’ve evaluated first hand. Those that don’t I’ve evaluated based on their own feature lists, demonstations and published materials. This isn’t mean to be a usability evaluation, but just an overview of what’s being done out there.
So, here’s the group that has my attention:
There are others. Lot’s. Why aren’t they listed above? They haven’t grabbed my attention yet. Am I missing someone exciting? Drop it in the comments!
A short digression on EHRs and disruption: In my *ever-so-humble* opinion, the innovative EHR is not a truly disruptive technology, by strict definition. Maybe Clay Christensen would disagree (in which case I would submit), or maybe history will prove me short-sighted and wrong. But, I believe that in spite of the exciting innovation in this space, EHR innovation won’t replace or up-end any markets, particularly the market that it most directly influences: the Doctor-Patient(-Insurance) transactional market. I do think EHR innovation may expand or create new markets. It will reduce waste and inefficiencies. It will improve care. But it won’t truly disrupt the market. It’s not going to take us from the realm of treatment/reaction medicine to preventative medicine. It’s not going to change the payer models. It’s not going to change the customer. It doesn’t fit the pattern of disruptive technologies layed out in The Innovator’s Dilemma. I see it as exciting evolution, but not revolution.
In an earlier post I wrote about the top 5 features I need and my patients need in an innovative EHR: Integration, Web-based Interoperability, Mobility, Provider Sharing and Patient Access. I’m going to evaluate how each of these EHR innovators does on meeting my top 5 needs, starting with Practice Fusion.
Practice Fusion is one of the more mature EHR innovators on my short list. Founded back in 2005, it began life as a truly bootstrapped startup. It’s now growing rapidly, boasts over 100,000 users, and is probably the most covered EHR innovator out there. So how are they doing?
They’ve already integrated with a lot of pharmacies and labs, which is great. But I’m looking for open integration, the kind that fosters new innovation and creates new markets. As a medical imaging expert, integration with medical imaging is especially important to me. Really I think it should be to everyone: medical imaging drives decision-making in modern healthcare. But more on that later.
Practice Fusion does have an API, and they have the vision for it. But, it’s not open to all yet. I’m hoping it will be soon, and when it is, we will look seriously at integrating Radiology Response with it. 1 thumb up, with 1 more to come when they open up the API.
Ok, this one is easy. Practice fusion is 100% web-based. Two thumbs up.
They do a nice job here, too. They have an iPad enabled design, and they use LogMeIn to prevent the need for repeated log-ins. An iPad app is on the way, and so are iPhone and Android apps. Nice job.
Sharing with other Providers
Your PCP probably want’s to see your oncologist’s notes. Your cardiologist probably want’s to see your pulmonologist’s notes. In fact, as a physician, I can tell you we ALL want to be able to share these records with each other. It let’s us do our job better, and more efficiently.
This kind of sharing is a large part of how EHRs can improve care. But, it’s also a complex technical challenge, with serious regulatory hurdles. Health information exchanges are built on this concept, and that’s great. But look, as a patient shouldn’t I be able to just grant access to whichever doctor I want, and revoke it when I want? Yes. Yes, I should. But I can’t. Even if we’re both using Practice Fusion. I understand this is not part of Meaningful Use Stage I, but it is one of the 3 major objectives of meaningful use. and I’m hoping this will come soon. It’s importance cannot be overstated.
No thumbs up here. Hoping to see this soon.
Sharing with Patients
Practice Fusion has a Personal Health Record with a secure patient portal, and an easy mechanism to enroll patients.
Overall score on the innovation scale: 7/10 thumbs up, with a bright future.
Next installment: drchrono.