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Which country(s) or company(s) do it the best? Let's learn from others.
by tabtab 8y ago
Which country(s) or company(s) do it the best? Let's learn from others.
- Someone1234 8y agoUnfortunately a lot of other countries do it better because they're in a completely different healthcare system. Which is to say that the focus of US EHR systems is billing, the focus in other countries is on patient care. That might sound like a trivial difference, but medical staff at US healthcare providers are required to record significantly more information in order for it to be reimbursed. For example in other countries you aren't recording supply usage on a "by patient" basis, but by ward or even by department. So patient charts are much simpler abroad. So you could copy a foreign EHR system but it would be completely unusable or require so much alteration you might have well start again. The issues are somewhat systemic. Even Medicare which is essentially socialized medicine in the US, has substantially higher documentation requirements than equivalent programs abroad.
- Scoundreller 8y agoFee-for-Service vs salary makes a difference too. In FFS, the quicker you finish, the quicker you go home for the same pay. When you’re salaried by the health system, it’s an easier sell to enter in your own orders and sell the downstream savings as funding your next pay increase.
- sixothree 8y agoMost of the innovation is happening in the FHIR space. And this is a very international space. As far as "interoperability" is concerned, we are all figuring this out together. edit: I should add that US budgeting funds for adding interoperability requirements sure does help.
- tuberelay 8y agoDoctor here - honestly, a paper record works great generally. The really useful low hanging fruit of EHR is an electronic portal for radiology results, blood results, discharge summaries and letters. If you have a way to link family doctor/pharmacy prescriptions with hospitals, thats great too. My ideal health IT system assuming perfect AI and everything else would be: - Automatic recording of everything discussed and done between nurses/doctors with no input from the doctor and producing a record which reads in a sensible way - Automatic prompting for things the doctor/nurse was likely missed or should discuss during a consult (but only to a sensible level of detail) - Automatic checking for common ommissions, or things that are being done that perhaps shouldn't be, so a patient who has a microcytic anaemia triggers a check to ask a doctor "do you want to order iron studies on this patient?"
- tabtab 8y agoSomewhere there must be a Rule of Automation saying, "Paper and pen/pencil is better than a bad system."
- hackerDoc 8y agoThat's the system we're building. We've been at it for over three years. Not long before we leave stealth mode and switch from R&D to commercialization. We're internally-funded, which means we don't answer to investors, we don't have to live in SV, SFO or NYC, we don't have to hire people the VC firms like/trust (we have senior executive experience at multi-nationals), and, most importantly, we can focus strictly on what's best for our colleagues and our patients.
- tim333 8y agoI heard the system in Southern Spain works quite well - some stuff here https://www.cbc.ca/news/technology/electronic-health-records-why-spain-is-getting-it-right-1.927868 https://www.cbc.ca/news/technology/electronic-health-records...