Wednesday, August 9, 2006

Medical Software Problems

Here is an interesting discussion about some problems with Medical Software. Unfortunately, this just begins to scratch the surface. I have been using and managing medical software for 5 years and I am amazed at how poorly a vendor can treat a customer once the contract is signed.



Some doctors who use Dr. Notes' electronic medical records software say they have been denied access to the program and their patients' medical records because they refused to pay increased technical support fees.

Multiple doctors cut off from records by Dr. Notes - South Florida Business Journal:



Fortunately, the situation isn’t entirely bleak. New online communities are developing to build and market free software solutions. LinuxMedNews is a regularly updated online forum for discussing industry news. GPLMedicine is a similar site maintained by Fred Trotter, project manager for the Free software ClearHealth management system. A project by Canada’s McMaster University, OSCAR, became the first IT system certified by OntarioMD.



Although these don’t have the name recognition among the medical community of commercial ventures such as Dr. Notes, they’re available for testing and implementation—free of charge and usage restrictions—today.



If you are a doctor or other healthcare provider, you owe it to yourself and your patients to take a look at these forums and applications. At the worst, you’ll find them uninteresting and unuseful. However, you could also find ways to protect your patients’ and your own best interests—all while saving money.



Your data or your life | Free Software Magazine



The Problem

Too many unique software packages and too few dollars for development.

If you look at it, the real value that a medical facility gives is the doctor's expertise. Sure there is lots of tools that a doctor needs to be effective but a doctor can still make good decisions without the fanciest equipment in the world. If you believe as I do, then everything else is just an expense to maximize the doctor's dollar. That means that there is less money to spend on software. At a conference a keynote speaker told us that medical facilities spend the lowest per revenue dollar on IT (IIRC 5% for medical and 10% for banking)



Medical facilities need multiple software packages to do very specialized and unique processes even for similar departments. For example, we use one software package to schedule radiology (Radiology Information System), one system to schedule clinic visits, and another to schedule patients that stay overnight. The reason a hospital needs 3 systems is because each system is better at managing it's department than a general scheduler. I haven't even covered the transcription department, the billing department, and the medical records department. I'm sure I'm missing some but you should get the idea.



When a medical facility shops for vendors usually they are lucky to find 2 competitors in a marketplace. Sure there may be many small boxed software but usually you find one very strong industry leader and a weak second place competitor. That vendor that you pick may be the best in the industry but since the other one is still using an abacus for calculations, the medical facility feels over a barrel.



The main thing I wanted to say was the medical field needs to start embracing open standards and open source software. It is too expensive for medical facilities to ignore. Medical facilities are also very keen on working with their competitors. We don't have a problem sharing information between other sites as long as they are not across the street stealing patients.



I believe that if HL7 had a BSD style license for their standard and maintained a slow backwards compatibility, interfaces between applications would drop to under $1,000 from the $10,000 we see today.  I'm usually a GPL guy but something as low level as HL7 you probably need the proprietary software guys and the open source software guys to come up with a standard.



technorati tags:, , ,