As a self-professed geek who has migrated to the healthcare field, I am amazed at the poorly designed and architected software and the high prices charged for it. In the business world, these companies would have been out of business because of lawsuits over nonperformance and reliability.
I see EHRs that are sold based on ancient technology and design. Real Web access is rare and modern architecture nonexistent. Instead we use Citrix to hide the fact that the programs can't run on a regular PC, much less on wireless devices. I see systems where they have to write volumes of scripts to handle fail over. I talked to folks at one hospital, where they still print off their health records because their system crashes so much. We spend a lot of money on single sign-on products (that still only partly work) instead of designing a coherent architecture in our institutions where that is a built-in feature.
I hate to inform the healthcare industry of this, but they should demand 99.999% uptime, guaranteed by the EHR seller. They should hire real technical people (yep, the old computer science people) to evaluate and design their infrastructure. I wouldn't let a business major perform surgery on me, but in healthcare, it seems perfectly reasonable to let someone with an RN or health information management degree design sophisticated technical architecture.
When buying a system, why don't we look at features such as database mirroring, backup and restore, data warehouses (after all, you need to get the data out to study also) and the ability to operate with other systems.
If I have ever seen an industry that needs cross-pollination from another sector, it's in healthcare. Success at implementing technology is often the difference between companies that make it or not in the rest of the world. Trust me, the same thing is going to happen in healthcare.
Michael WatterudClinical decision support analystCovenant HealthCare Saginaw, Mich. To submit a letter to YOUR VIEWS, click here. Please include your name, title and hometown.