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It's all like that. Medical software is a ghetto. I think it's partly because those who have a passion for the industry aren't good developers and good develop

by bena 4y ago

It's all like that. Medical software is a ghetto. I think it's partly because those who have a passion for the industry aren't good developers and good developers don't have a passion for the industry. Not to mention a lot of decisions are driven by medical doctors and if you think software developers believe that being good at one thing makes them good at all things, you are going to love medical doctors.

philwelch 4y ago
It's also heavily regulated, which it probably should be, but that has certain tradeoffs and consequences.
- deleted 4y ago
  [deleted]
- caycep 4y ago
  regulated...by the HHS panel that conveniently includes Judy Faulkner, CEO of Epic...
devilbunny 4y ago
That's certainly an issue, but one thing that MD's (I am one) are very, very good at is knowing whether a system makes their lives easier or harder. Paper charts had their problems - unreadable handwriting, limited accessibility - but they were a very heavily refined system that served the doctors and nurses who used them daily. EMR's are largely written to maximize billing, not end-user convenience. I'm an anesthesiologist, so there's really nothing for me to up-code in order to get paid more for the same work (except that I can declare the patient to be higher-risk, or the surgery to be an emergency, each of which nets my group about $20). It's baked into the system, based on what surgery is being performed. So EMR has been good in that I can find old information more easily, and Epic in particular allows me to get information from other health systems that use Epic, but as a practical matter it's not a big improvement in general from the old system in which paper notes were scanned in after discharge and all dictations (admissions, discharge summaries, any procedure notes) were transcribed into it. But it sure did cost a lot of money.
caycep 4y ago
I feel like it's not even medical doctors, it's the CIO/hospital administrators and the insurance companies that drive most of the software decisions, since that is where the money for these large Epic deployment contracts come from and they are the true "customers". Most medical doctors don't even know where to start when asked re software decisions.

by bena 4y ago

philwelch 4y ago

It's also heavily regulated, which it probably should be, but that has certain tradeoffs and consequences.

deleted 4y ago
[deleted]
caycep 4y ago
regulated...by the HHS panel that conveniently includes Judy Faulkner, CEO of Epic...

devilbunny 4y ago

That's certainly an issue, but one thing that MD's (I am one) are very, very good at is knowing whether a system makes their lives easier or harder. Paper charts had their problems - unreadable handwriting, limited accessibility - but they were a very heavily refined system that served the doctors and nurses who used them daily. EMR's are largely written to maximize billing, not end-user convenience. I'm an anesthesiologist, so there's really nothing for me to up-code in order to get paid more for the same work (except that I can declare the patient to be higher-risk, or the surgery to be an emergency, each of which nets my group about $20). It's baked into the system, based on what surgery is being performed. So EMR has been good in that I can find old information more easily, and Epic in particular allows me to get information from other health systems that use Epic, but as a practical matter it's not a big improvement in general from the old system in which paper notes were scanned in after discharge and all dictations (admissions, discharge summaries, any procedure notes) were transcribed into it. But it sure did cost a lot of money.

caycep 4y ago

I feel like it's not even medical doctors, it's the CIO/hospital administrators and the insurance companies that drive most of the software decisions, since that is where the money for these large Epic deployment contracts come from and they are the true "customers". Most medical doctors don't even know where to start when asked re software decisions.