I was thinking the other day about my heart attack six years ago.  As I was awaiting my angioplasty it occurred to me that although I had a pretty good idea about what was about to happen, I had absolutely no input or information about who would be performing the procedure.  What I wanted was input and information somewhere between the extremes of ‘none at all’ and how to perform the procedure on myself—Type A personality.

I wouldn’t have felt they way if I was having a plantar wart removed, or repairing a broken bone, but we’re talking about my heart.  From the back of an ambulance nobody asks you who you want for a cardiologist, you go to whoever happens to work at the hospital.  It’s a little like getting a haircut—I go to whichever barber is available.

I don’t care who cuts my hair, what’s left of it, but I do care about who might have to operate on my heart.  Through some connections I have at CHOP I received the names of three cardiologists, I interviewed them, and made my decision.

This got me to thinking about how doctors might view this entire EHR issue.  I asked myself if I was a doctor, what would I want to know?  What is the proper balance of input and information I need to be able to make a reasoned decision on EHR?  It lays somewhere between, “I’ll code my own,” and “Call me when you’re done.”

I don’t want to buy something simply because a sales rep tells me it’s a good idea.  I also don’t want an associates degree in IT.  For me, the ideal solution would be to have someone bring me three or four good choices, provide me a business perspective of the pluses and minuses of each, and information about the cost, the impact to my practice, and the training.  Show me the cost breakdown of having my own versus having it run elsewhere.  Having enough information upon which to make an informed decision, once I’ve made it, I’d like to be able to do my work, and have whomever I’ve selected install it for me.

In effect, I’d like a “wrap around” EHR.  Perhaps it handles the practices in my office, perhaps the ones in my building.  Maybe someone else hosts it; maybe I can get it integrated with my billing.  I’d like it to include my federal reporting requirements.  I’d like it to facilitate peer learning, and have customizable work flows, on-line training via a learning management system (LMS), and help desk and support rolled into the package.  I want whoever is doing this to clean up my records and have them present in the new system.  I also need to know what will be done if my computer gets fried or the building blows up.  Lastly, I want somebody to manage this whole process on my behalf, somebody who can make sure that what I think I bought is what I get.

What do you think?