I’ve been baffled by the initiative to have doctors “connect” with each other and the plethora of electronic medical records (EMR) software on the market. In no way can one imagine that information sharing is wholeheartedly embraced, rather it is grudgingly so.
In a business sense, there is absolutely no business rationale to write software that cooperates with a competitor. Governmental regulations can “force” or “compel” interoperability, but if done with resentment, there will never be true information sharing.
Thus we come to the current enigma of “meaningful use” where software products must demonstrate information sharing in some form. If software had been built from the ground up to fight information sharing, how can it double back to do so. It cannot! In essence it is an added or bolt-on feature that suffers from a lack of foresight that such a need was envisioned or required.
It’s possible to demonstrate “meaningful use” to the satisfaction of some defacto regulation, but deeper information sharing that could meet a future social need might not be possible. The solution, therefore, is to program the EMR software from the concept stage to share information in some fashion.
When you think of what CIOs in big hospitals or individual doctors contemplating a purchase, there is absolutely gratuitous for a vendor to guarantee that their platform can be faithfully adapted to information sharing when its heritage had begun with an eye to proprietary and closed systems.
This brings the next dilemma. With 300 major software products on the market, how should health information exchanges in each of the fifty states choose for their member entities. It is unrealistic to believe that all 300 should be available but certainly a subset of maybe 10 or 20. It only makes sense that economies of scale can only be achieved if there is some standardization on a few vendors rather than all.
In summary, software may be dressed up with new technology. They may even act like they can share information. But can it really? Can a particular EMR software product born during the proprietary age of software transform or transition to an edge of information sharing? If it can, what kind of additional program modification is necessary to achieve it? The next time you sit down to sign that sales contract, hesitate for a moment and see what you will wrought on your organization.