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There has been a lot of noise regarding open source software as an alternative to the expensive software that are currently out there.  Currently proprietary systems cost a couple millions dollars and that is before the additional cost of servers, networks and consultants.

However, while open source software is free, the cost of servers, networks and consultants for support still exist.  The worse part is the lack of support if you encountered a bug of some sort.  Even though there are open source communities, there is a chance that the community will become stall.  At this point you are left with outdated software with no support.

Personally I like to see the adoption of open source EHR software rather than the usage of proprietary software.  The vendors are charging an arm and a leg from hospitals that are already suffering in the current economy.

One of the biggest benefits to EMR system implementation and upgrades belongs to IT professionals.  Even after the purchase of EMR software, someone has to setup the servers, configure the software, and perform quality assurance of the software.  This is great news an industry where the major players have picked up the number of job offshore due to the economy.  (Although health care IT can also be offshore, especially those that build reports). 

An article from eWeek pointed out an increase of system integration, programming, project management, and training jobs as a result of the 20 billion allocated in stimulus package.  The article also points out the potential of additional cost to a hospital such as network, and lost of productivity.  Definitely worth a read.

According to KCBS,

Senator Barbara Boxer got an up-close look at a cutting edge medical records system in Oakland Tuesday.Kaiser Permanente patients are linked electronically to their doctors and the entire Kaiser system through a sophisticated computerized medical records network.

Kaiser Permanente is known for implementing Epic’s HealthConnect.  Although the cost of implement HealthConnect has soared in comparison to the original estimation it is definitely one of the largest EHR implementation.

With all the acronyms that are flying around with  health care, HIE (Health Information Exchange) is one of the recent buzz terms.  The idea behind HIE is different EHR (Electronic Health Records) applications can exchange information easily and thus provide a complete picture of a patients health as he/she move from one clinic to another.

The National Health Information Network is created to come up with such a standard.  Previously HL7 messages were created as a way of information exchange.  However, after personally working with HL7 messages, there are a lot of issues with the way HL7 messages.  The definition of HL7 attempted to provide flexibility by enabling one field to be coded in multiple ways.  However, this makes integration difficult as some client might decide to code their messages one way while the other clinic decide to code it another.

The National Health Information Network can be seen as another attempt to come up with a workable standard with three phases:

Phase 1: Prototype Architectures

Phase 2: Trial Implementations

Phase 3: Limited Production

Hopefully there are enough feedback from folks who has worked with data integration in the past where some of the current issues can be resolved.

The news that came out last few days is regarding U.S. government granting almost $1.2 billion to help hospital establish and use electronic health records and the debate that is currently surrounding it.

As stated from the article:

The funds are dedicated to establishing approximately 70 Health Information regional Extension Centers across the country and to support states’ efforts for information sharing within the emerging nationwide system of networks.

The problem I see is a problem of lack of standards.   I have not seen a good way in which a patients data in two hospitals can be exchanged frequently.  I see this as a master data management problem.  Every hospital assigns an unique medical record number to their patients.  However, this medical record number can itself change within the same hospital.  Now think about a patient that visits three different hospitals.  What you have is potentially three different sets of patient data that you have figure out a way to merge them.  Without a standard, additional money given by the government will simply go down the drain.  More effort will be wasted on installation, configuration, and maintenance of software.

On a positive note, this is very good news for technology workers.  Technology workers will be able to find more work in software related field when the large technology companies are massively off-shoring technology jobs here is the state.  The government grants will be beneficial, but not necessary to the health care industry.

NextGen is currently offering a free web seminar for EHR/EPM software as a service (SAAS).

According toe NextGen’s description:

NextGen Healthcare has introduced a competitively priced Software-as-a-Service (SaaS) subscription model that allows small practices to benefit from the industry’s leading EHR and EPM software without the typical upfront costs. In this webinar, you will learn:

• How subscription-based pricing works and which features are included
• How to quickly document a patient visit and perform/order tests immediately
• How to improve appointment scheduling and billing

Sounds like a good opportunity to explore different EHR options.

Everyone who works in the health care IT industry knows that EMR systems tends to very expensive.  In addition to the cost of software, there are also the cost of buying the server and hiring consultants to set everything up.  (Assuming there isn’t an IT department in house).  Even though it seems like the government has allocated a lot of stimulus money to digital health care records, the amount of money a physician can get pale in comparison to the cost.  If the implementation of an EMR system is not carefully considered, the cost will easily sour.

As for iChart, even though is not CCHIT certified, it does provide a good flavor of the usefulness an EMR application can provide to the physicians.  Personally I will buy the app just for the quick lookup of CPT/ICD9 codes functionality.