Why we cannot get there from here!


Our best wishes during this season of Thanksgiving to all of our students, faculty, colleagues, and followers. I myself am in a right handed cast following wrist arthroscopy for SLAC (scaphoid lunate advanced collapse). More on SLAC at a later date. Today the urgent topic is why we cannot get there from here!

I am speaking about the collective challenge that all health care providers face as we cope with the data requirements of health reform. By now, most providers are well versed in speaking the language of Cerner, Epic, Allscripts, and the like. Can you speak the language of reform? This is the key question on my mind.

The language of reform says, in my view, that you will need a registry to evaluate the population of patients for whom you are responsible. A provider must be able to come into the office, switch on the computer, and nearly effortlessly assess his own performance relative to a peer group as it relates to a population of patients. For example: In my own primary care practice, I should be able to instantly get good data on the patients I care for who share a certain diagnosis. I should be able to quickly assess my performance and learn new ways how I might improve. I should be able to do this with a minimum of fuss! There is just no way in my mind’s eye that I can envision the Cerners, Epics, and Allscripts of the world to be able to carry out this function.

We need a new generation of software to sit on top of these classic software boxes. The current EMR is really an electronic chart, not a tool for improvement at any level. I am intrigued then by the work of Anvita, Anceta, Phytel, Sandlot, NetOrange, Quantumleap, Humedica, Vree and others… can they get us where we really need to go?

I am interested in learning from our colleagues – will the current tools get us where we have to go? If the answer is no, as I contend it is, then what does the road ahead really look like as we build the analytic engine necessary for reform?


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