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    Doctors to EHR vendors: You need our input

    None of the doctors Medical Economics spoke with said an EHR vendor has ever responded to suggestions on how to improve their products. 

    “On several occasions I’ve tried to get in touch with [EHR manufacturer] Centricity [Practice Solution] about some easy corrections I’ve thought they could make and never heard back,” says Keith Aldinger, MD, a Houston internist in a two-physician practice and survey participant. “It’s a bit troubling that they don’t seem to want to work with the physicians, because it’s the end user who has to be satisfied. But if anything, it seems like it’s harder to navigate than it was when I started using it 10 years ago.” 

    Aldinger notes he started using Centricity around the time Apple introduced the iPhone. “If you look at the improvements in [the iPhone’s] usability versus the EHR, there’s no comparison,” he says. “I can’t think of any another product [than EHRs] that has performed so poorly, and not only survived but with abundant profitability. It’s just unbelievable.”

    James Dunnick, MD, FACC, who provides EHR training to other doctors as head of The Dunnick Group, LLC, in New Orleans, sees a simple explanation for why EHR vendors rarely ask for doctors’ input regarding quality improvement: They don’t have to. Medicare payment reform and other government policies mean that most practices and healthcare institutions are virtually required to have an EHR, he points out, providing the EHR companies with a guaranteed market for their products. And the Meaningful Use program, during its existence, subsidized their purchase. 

    Regardless of any shortcomings in the technology, “they’re still going to make the sale, and then when you [the customer] don’t like it, it becomes your problem, not theirs,”  says Dunning, a survey participant who still practices internal medicine part-time. “And then it’s so expensive to change systems, the customer just won’t do it, and would rather limp along with an unhappy staff.”

    Cuthbert (MEDENT): This is excellent input that speaks to the core of what an EHR system should be taking into consideration at all times. As a vendor, it is easy to get caught up with the excuses that there are deadlines to meet to stay compliant with ongoing [federal] regulations. Since these are requirements that consume a lot of resources, it can be fairly easy to become unresponsive to the practicalities an EHR needs.

    The vendor is in a test tube setting. The people creating the system's new features or work flow tend to be technical in their natures. This is why it is essential to have more laypersons looking at the simplicity, efficiency and common sense of the end result. During the development process you need to be intuitive, objective and mindful of each end user’s varying train of thought.

    Once a project is ready for field use, it’s never really truly final. It is very important to listen carefully to early user feedback once it is put into real-world use. Furthermore, it is imperative that the necessary tweaks and adjustments are made to make sure the end result is very solid, efficient and logical.

    The influence on programming usually comes from several sources including the practices, users, government, industry trends, insurance carriers and the vendors own vision for the future. We have the responsibility as a vendor to maneuver with a high level of integrity while still staying attentive to the physician's needs.  


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