Dinosaur MD says “Make Mine Paper” and “no thanks” to EMR vendors

A friend of mine sent me a note to take a look at Make Mine Paper by a blogger who calls himself "#1 Dinosaur, MD". It’s a well written article that explains why there are some physicians who will never use an EMR. Some choice words:

Until there is a single, interoperable system in wide use, EMRs will never have the portability and versatility of paper. Just imagine the chaos that would result if doctors’ offices used 8.5-in by 11-in paper for their charts, but hospitals all used legal-sized paper; labs reported their results on 4-in by 6-in cards, and x-rays were reported on 5-in by 8-in slips. Trying to keep all of those different sizes and shapes of paper together in 1 folder would be a nightmare. Now multiply that several hundred-fold.

He’s certainly right and I like his explanation of lack of interoperability; in fact, it’s one of the best analogies I’ve read. He goes onto say:

The fragmented market of EMR suppliers isn’t just as simple as PC vs Mac; there are hundreds of vendors selling different systems, each of which works differently and none of which are capable of interacting with each other. The only way to transfer records from one system to another is to print it out on paper and then scan or manually re-enter the information into the other.

This is where I disagree — the reason that systems aren’t interoperable and can’t interact with each other is because customers are willing to accept vendors who don’t work well with each other. It continues to surprise me how easily healthcare IT customers accept mediocrity from their vendors and sign contracts and make purchases that are only good for vendors.

With HL7 we have some a "good enough" interoperability solution and there are tons of tools and many vendors out there that will connect disparate systems.

How many of you out there are being held hostage by their healthcare IT vendors?

Newsletter Sign Up


4 thoughts on “Dinosaur MD says “Make Mine Paper” and “no thanks” to EMR vendors

  1. With respect to the paper size analogy, too many healthcare facilities are stuck in this very expensive paper jam. It’s unfortunate that some physicians feel the only way to go is backwards – the paper route. We should all be moving forward. You can not assure standards of care or measure outcomes without a closed loop management system and clinical database. Paper chart reviews are too expensive, too narrow and an inefficient path to improved quality. An Open Source EHR system is the way to go. VistA, for example, is an interoperable system. It is also a proven system, created in the public sector within the VA hospital system. 65% of all physicians trained over the last 15 years have used VistA during a VA rotation. It has had a record of rapid adoption, increased physician productivity and high levels of acceptance. OpenVista, the commercialized version of VistA, is now in use in dozens of facilities. We don’t need to re-invent the wheel or be dinosaurs when there is a proven open source system paid for and readily available.”

  2. That is a very interesting topic. Actually, Gartner analysts predict that, by 2009, healthcare investments in IT will increase by more than 50 percent, which could enable clinicians to reduce the level of preventable deaths by 50 percent by 2013. Of course, nowadays most healthcare organizations have already invested in IT outsourcing, for anything from Telco and Wireless, to Application Data Development (i.e. LIMS, SOA), or even Business Process Management.
    We’ve put together a detailed white paper on these subjects: http://www.outsourcing-factory.com/en/stay-informed/white-papers/outsourcing-healthcare.html . What is your experience with IT outsourcing in healthcare? Are these figures close to your personal experience or do you think there are certain issues we’ve missed covering? I strongly appreciate your professional opinions.

  3. There's also no interoperability at the device level. I have diabetes and none of the various devices I rely on to stay alive have common data formats.

    Part of the problem is that the medical industry is in the dark ages technologically speaking. HL7 solves some of the problems, but it's challenging to understand fully and expensive to adopt so it's not easy to implement.

    Customers could insist that vendors are compatible with each other, but there are many shades of gray in the words compatible, interoperable and interact.

  4. There's also no interoperability at the device level. I have diabetes and none of the various devices I rely on to stay alive have common data formats.

    Part of the problem is that the medical industry is in the dark ages technologically speaking. HL7 solves some of the problems, but it's challenging to understand fully and expensive to adopt so it's not easy to implement.

    Customers could insist that vendors are compatible with each other, but there are many shades of gray in the words compatible, interoperable and interact.

Add Comment