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Reinventing the Electronic Medical Record (EMR)

Reinventing the Electronic Medical Record (EMR). Position We are making a national investment of billions of dollars to scale up the use of EMRs to improve the access, quality and cost of care in the US.

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Reinventing the Electronic Medical Record (EMR)

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  1. Reinventing the Electronic Medical Record (EMR) Position We are making a national investment of billions of dollars to scale up the use of EMRs to improve the access, quality and cost of care in the US. There are seven major challenges to using our current products (EMR 1.0) to achieve that goal. Fortunately, we can meet all seven challenges but doing so requires a complete rethinking of products and approaches. We need to develop an EMR 2.0. This presentation describes the challenges with scaling EMR 1.0 and how EMR 2.0 will meet them.

  2. Seven EMR 1.0 Challenges • Implementation Complexity • High Cost and Low Interoperability • Limited and Delayed Value • Lack of Cognitive Support • Information Sharing Disincentive • Improved Care Disincentive • Threaten Provider Business Model

  3. EMR 1.0 Implementations are long, complex and involve large software modules that cause significant disruptions to operations EMR 2.0 Rearchitect from transaction-oriented modules to small components and services that can be implemented quickly and used as needed 1. Implementation Complexity

  4. EMR 1.0 Costs are too large for many clinics and hospitals. Patient data is locked in as EMR 1.0 does not promote exchange between payers and providers EMR 2.0 Use cloud computing to dramatically lower costs and achieve interoperability within the enterprise, across enterprises, regionally, nationally and globally (e.g. medical tourism) 2. High Cost and Low Interoperability

  5. EMR 1.0 Benefits can take years to realize and are hard to measure EMR 2.0 Focus first on creating value not simply turning paper forms into electronic documents (value informatics) 3. Limited and Delayed Value

  6. EMR 1.0 Does not provide natural support for strong situational awareness, making effective decisions or changing behaviors EMR 2.0 Go from data to semantic content and knowledge to provide a world-class level of cognitive and behavior change support 4. Lack of Cognitive Support

  7. EMR 1.0 Have to spend time capturing, using and sharing information with no direct benefit EMR 2.0 Provides a fee for information service, to those that have vital information but do not directly receive a benefit from capturing, sharing or using it 5. Information Sharing Disincentive

  8. EMR 1.0 Sharing information and improving care will lower provider revenue EMR 2.0 Create an electronic marketplace to implement P4P incentives to accelerate the adoption of best practices in preventative, acute and chronic care 6. Improved Care Disincentive

  9. EMR 1.0 Allows new entrants to influence patient’s consumption decisions and threatens providers business model. You are eating my lunch! EMR 2.0 Offer forward thinking providers caught on the wrong side of the value migration an opportunity to reinvent 7. Threatens Provider Business Model

  10. Recap of EMR 2.0 Solutions • Develop a service-oriented architecture (SOA) for EMRs • Deliver EMR services from a cloud computing platform • Build high value applications from the cloud-based services rather than automating forms and paper charts • Develop semantic or knowledge-based services that directly support situational awareness, decision making and behavior change • Provide a mechanism for determining, tracking and paying P4P incentives to support the information sharing and improved care needed to drive EMR 2.0 services • Offer new information-based revenue opportunities to providers that face business model disruption

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