GUEST POST from Arlen Meyers
Doctors are unhappy about electronic medical records.
- Nearly 70% of physicians say electronic health record (EHR) systems have not been worth it
- EHR usage is accounting for 48 minutes of lost free time per day.
- 73% of the largest practices would not purchase their current EHR system
- 45% of respondents say patient care is worse since implementing an EHR
The healthcare digital ROI is not meeting expectations. Only the vendors making billions seem happy.
When it comes to communicating, it seems, techologists are from Venus and doctors and other end users are from Mars. The present offerings are not meeting the needs of users, are too complicated and filled with features, not benefits, and they offer smokestacked parts of a solution. Instead, we need a whole product solution that would include the next generation EMR.
The whole product
The whole product bridges the gap between the marketing promise your company makes to customers and your product’s ability to deliver on that promise. It includes all the products and services that are necessary to augment or complete the product so that it becomes a complete solution and lives up to its value proposition.
The four layers of the whole product
- Generic product: the product that ships when a purchase is made
- Expected product: the product the customer believes he buys when he orders the generic product
- Augmented product: the idealized form of the product that provides the greatest chance that the customer will achieve his stated buying objective
- Potential product: the apparent growth path of the benefits demonstrated by the product as it is improved, and as it is complemented and strengthened by other products and services
We are now in the ecosystem economy.
TVs were worthless without a network. Electric cars won’t scale until there is a national electic charging grid. Digital health won’t mature until there is a coordinating cyberbrain.
So, what’s your strategy? Can you answer these five questions?
Customer jobs, pains and gains describe problems. Gains describe all the customer’s wanted and unexpected benefits and desires, and may span personal, functional, or economical etc. For example, this box could include positive emotions, functional requirements, or specific cost savings and can be rated as “WOW, I sure didn’t expect that” to “not having this is a deal breaker”.
So, what would a whole digital health product look like?
1. Interoperable with other whole products. For example, suppose all EMRs and the internet of things were interconnected? What impact would that have on the global aging population?
2. Intuitive user interface with minimal workflow disruption.
3. Designed to achieve the Quadruple (includes the doctor experience) Aim of improved quality, reduced per capita costs and an improved patient nd doctor experience.
4. Validated that it achieves #3
5. Incorporates modules that include not just EMR, revenue cycle management and business process/practice management support, but eCare as well, including decision support, telemedicine, remote sensing and other parts of digital health.
6. Accessible anywhere, any time, using any mobile device.
7. AI support to avoid unnecessary data entry requirements by the user.
8. Accessible to the community of care, not just closed loop providers, anywhere in the world.
9. Ability to modify security and confidentiality requirments to suit the needs of the care team and patient team.
10. Inexpensive or. preferably, free
11. As population health management demands increase, so is the demand for an information and communications health solution. For example, in an attempt to expand its population health footprint, Siemens Healthineers — the healthcare unit of Siemens AG — has signed an agreement to acquire Medicalis Corporation, a company based in San Francisco, California, and Kitchener, Ontario, Canada. Components of the platform include decision support, referral management and patient and doctor parts designed to improve the patient experience and engagement.
12. Cybersecure
Here are some more benefits, not features:
1. A whole product solution that integrates telemedicine, social media, etc
2. Voice to text entry
3. Better UI/UX
4. Better decision suppport
5. Interoperabilty
6. Patient owned
7. Integration with IoT
8. Automated bill generation based on data mining
9. Patient friendly format for patient participation that does not interfere with workflow during the visit
10. Better biometric activation across multihospital systems. Eliminate passwords
11. Translation function for clinical summaries for non-English speaking patients
12. Clinical translator for patients who don’t understand medical terms
13. Cheaper, smaller, better systems for independent practitioners who can’t afford to and don’t need to buy the whole enchilada
14. Change the billing rules that are driving ecosystems that create ridiculously complex and costly systems to operate
15. Include costs of prescribed tests, medicines and other therapeutic interventions in real time at the point of care and other options to reduce them. Give us the answer when the patient asks, “What will all this cost, doctor?”
A hospital centric EMR is not a long term viable model given the multiple points patients generate sick care and disease prevention data from non-traditional sources. Some have suggested the need for more robust pipelines, delivering data to a central repository and directed by middleware.
Here are some EMR trends that are likely to drive the continuing evolution of a health IT/EMR whole product solution. Another is integrating decision support science tools into the EMR, instead of relying on free-standing websites or apps.
We are getting closer. It’s been fewer than two months since Apple announced its pilot with a handful of vendors, allowing patients at certain provider sites to download their EHRs directly through the iPhone Health app instead of using a provider portal. But it’s not clear yet how the partnership is going – vendors and providers have generally been reluctant to share details about user numbers during the beta phase.
Dribbling out bits and pieces of a complete health information technology solution is causing more problems that it solves. Administrivia, reporting requirements and having to jump through burdensome and expensive hoops to get paid is causing unintended consequences and there is little evidence that it is meeting the Triple Aim goals.
We need to stop making things a la carte. We need the whole enchilada.
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