Joel Barker’s paradigm shift question for businesses has been used for years. It is a simple yet profoundly thought provoking question (paraphrased here):  What is the one thing we “can’t do” but if we “could do”… would fundamentally change the way we do business? 

What is the current EMR/EHR challenge for most large users is that they can’t change from current solution. For many, that means MUMPS (Multi-User Multi-Programming System). According to Wikipedia, MUMPS is a 47- year-old language intended for and designed to build database applications. It is used by Epic Systems, GE, Quest, et al.

MUMPS is used extensively by the U.S. Department of Veterans Affairs inclusive of “nearly the entire VA hospital system in the United States, the Indian Health Service, and major parts of the Department of Defense CHCS hospital system use MUMPS databases for clinical data tracking.”

Ring any bells?  According to recent press releases, the joint VA-Defense health record system isn’t going to happen. “It is a tough path and we decided to get off it,” said Frank Kendall, undersecretary of defense for acquisition, technology and logistics. “The cost for that would have been exorbitant. The last estimate I saw was $28 billion life-cycle costs.”  And, the billions of taxpayer dollars already spent.

We are seeing new and innovative ideas emerging, but every road to market will be hard won. “According to KLAS, Cerner and Epic capture more than 75 percent of large hospital contracts while the others–Allscripts, McKesson, Meditech and Siemens—struggle. In fact, Allscripts, Meditech and Siemens, according to KLAS, are being squeezed out.”  (Cerner uses Cerner Command Language)

KLAS report author Colin Buckley was quoted as saying “The HITECH Act that started this mass migration is clearly not over. There are over 400 large hospitals that still do not utilize a currently marketed EMR and thus still face a decision. The question is which way they will go and which factors will guide that decision.”

Innovation in information technology is coming; DIY trends are emerging from the frustration around current solutions. People, people who don’t know they “can’t do it” are asking great questions and creating a paradigm shift opportunities.

Here are a few innovative ideas, and emerging trends:

• Co-founders of ElationEMR, Kyna Fong and Conan Fong hope to revolutionize the way physicians use electronic medical records (EMRs).

• Medical student, Roheet Kakaday attending Oregon Health & Sciences University School of Medicine prototyped “Flo” a gesture-based patient-centric mobile EMR (mEMR).

• BuildYourEMR founder and COO, Anshu Jindal, has her own experiential story; it is compelling. BuildYourEMR starts with existing forms, workflows, and terminology to help design physician work-flow friendly solutions.

• Some MDs are creating proprietary solutions. Rob Lamberts, an internal medicine-pediatrics physician, has posted blogs about his efforts.

Is this a growing trend? Certainly innovation is transforming healthcare. For EMR/EHRs, a paradigm shift just may change the playing field. Many are asking the hard question, what if we could change our current EMR/EHR solution?

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References

MUMPS (2013). Wikipedia, the free encyclopedia
http://en.wikipedia.org/wiki/MUMPS

Philpott, T. (August 6, 2013). Sequester damage detailed; E-Health record goal slips. Retrieved August 28, 2013, from http://progress-index.com/news/sequester-damage-detailed-e-health-record-goal-slips-1.1531243

Goedert, J. (August 27, 2013). Report IDs Wins & Losses for Large Hospital EHR Vendors. Retrieved August 28, 2013 from http://www.healthdatamanagement.com/news/hospitals-ehr-electronic-health-records-market-share-46517-1.html

Winston, H. (August 26, 2013). Billions wasted on fruitless bid to create paperless Vet health records. Retrieved August 28, 2013 from http://investigations.nbcnews.com/_news/2013/08/26/20183344-billions-wasted-on-fruitless-bid-to-create-paperless-vet-health-records?lite

Press Release. (August 27, 2013). The Gap Between EMR Vendor Market Share Widens. Retrieved August 28, 2013, from http://www.digitaljournal.com/pr/1433603#ixzz2dHBAa0GV

KLAS Enterprises, Clinical Market Share 2013 – Report http://www.klasresearch.com/klasreports/#/krms/48/0