Modern Healthcare: Not enough time for PCAST goals?

Below are the comments I submitted to their recent article–

It is difficult being the lone duck screaming “the sky is falling,” but, I feel someone has to be the schismatist before we all wind up drowning in the Kool-Aid.

It is not that I do not think ideas like a universal exchange language are not important; I think the fact this discussion even exists is because we have kidded ourselves for so long about how well EHR and interoperability are working that we have hung ourselves on our own petard.

Have we put the cart so far ahead of the horse that we have caught the horse from behind?  The discussion seems to be about walking before most have learned to crawl.  Lest we forget the issues, here are some observations we must keep at the forefront—what most hospital executives and CIOs face daily.

  • EHRs are not standard
  • Many EHR implementations have failed
  • More will fail Meaningful Use
  • Some hospitals are on EHR 2.0, switching from Vendor A to Vendor B, while others are switching from Vendor B to Vendor A—what does that tell us?
  • The current hospital business model is dysfunctional; as compared to other industries, hospitals are run more like a 0.2 model than a 2.0 model
  • EHRs were built to support a dysfunctional model, and those EHRs are built using outdated architectures
  • An ACO business model is not compatible with the present crop of EHRs—EHRs were not built with ACOs in mind—they are mutually exclusive concepts, at least with regard to today’s EHRs
  • For and ACO to be of value, to be effective to an organization, they must be joined to a different business model

Before we worry ourselves with future issues like compatibility with the EU and a universal exchange language, ought we not come up with a plan to make EHR viable one hospital at a time?


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