
Paging Design M.D. - micrypt
http://blog.kyrobeshay.com/paging-design-md
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famousactress
FWIW, this is pretty much exactly what we do @
[http://elationemr.com](http://elationemr.com)

I understand the cynicism in a lot of the comments here about it being
impossible to compete against existing juggernaut systems, ridiculous 500k
servers for small group practices, and even the bits about nobody caring
enough to fix it.

I've been in Health IT for something like a dozen years, and it's true that it
can be a serious pain in the ass. At Elation I think we're doing the right
things to turn the tide. We're selling a really amazing clinically focused EMR
system to physicians (not to their C-level hospital administrators), and so
far they love it.

There's a ton to do and we're a tiny team. If this problem resonates with you
please do get in touch. It's easy to find folks that want to work on dropbox
or the next YC Airbnb-for-X but not as trivial to find folks thrlled (or crazy
enough?) to tackle the mission we're on. My contact information is in my
profile.

Apologies for the plug, seemed appropriate enough to be warranted.

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tom_b
GUI and visualization tools seem to be an afterthought for the big EHR
vendors. Peeling the surface layers off of EHR systems, it seems they are
essentially big ERP systems with a medical bent. So they require multitudes of
system-building consultants, nine figure purchase prices, and a bigger focus
on making sure billing/procedure auditing can be done by administrators than
facilitating MD/patient dataflow.

FTA: "why wasn’t the EHR already doing the legwork, displaying these
potentially pertinent correlations and data points, painting a more
descriptive clinical picture, instead of leaving me to wade through mounds of
information?"

Because the focus of the EHR system is about billing and tracking medical
record treatment for hospital administrators (auditing) rather than enhancing
clinical treatment and understanding for MDs?

Probably a large opportunity here to do cool and better GUI and visualization,
but good luck getting past the EHR vendor guard dogs to even read-only access
the back-end data.

~~~
andyzweb
>but good luck getting past the EHR vendor guard dogs to even read-only access
the back-end data.

I've had first hand experience with this. If you're going to build a startup
in this area it is important to be a stealth mode as possible. It's also
important to have a budget for legal services and LegalZoom™ won't cut it.

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odonnellryan
I completely agree. I work with several of these, and I'd really like to help
make them better.

There's no reason why an EHR used by 100 employees needs a $500K Dell server
to run, doesn't support load balancing (but needs it, since the app can't
handle more than 40 users, so you need a bunch of VMs on that server) and uses
up hundreds of gigs in the database (wikipedia is like, what, 50gb
uncompressed...?)

They suck, there's a market.

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keithflower
I'm a physician. While musing about clinical reasoning based on robust tools
like Kanren and miniKanren, I wrote a few thoughts that parallel the article:

"Much if not all of the current talk around clinical software unfortunately
stops at electronic health records (EHR) – the paper chart (with all its
limitations) mirrored in various incarnations of ‘the cloud’ (with the
additional disadvantage of confidentiality rot). For all the endless effort
put into EHR, it was a problem solved long ago with nothing more than punched-
card-fed mainframes. All we are seeing now is the iterative pursuit of
competing data interchange platforms."

"Physicians and researchers need software that advances the goal of making
routine things routine beyond just the level of data storage and retrieval…
_to decision support, data discovery and visualization, unsupervised ontology
construction, and scripting of reasoning agents. "_

[http://apps.keithflower.org/?p=238](http://apps.keithflower.org/?p=238)

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mkbrody
Would it be easy to sell a more advance EHR to hospitals if you could show it
would cut down on malpractice? Sounds like all the comments are saying
penetrating the hospital market has huge barriers. But if this is obviously
better, and could save time & lives, they should use it.

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caycep
forget design, from what I've seen of these systems, physicians would be happy
to have a system that doesn't require them to log in 4 times in some rube
goldberg contraption of a VNC in order to actually open the medical record...

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acconrad
This is a common complaint amongst doctors. I'm not exactly sure how a call
for design can really work. How can a future startup compete with these
juggernaut EHR systems on design alone?

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angersock
tl,dr:

Better design will save lives, and EHR sucks.

1 is true, 2 is true but nobody cares enough to fix it.

You cannot begin to imagine the amount of fuckheadedry on parade in any
hospital by the combined egos and efforts of doctors, administrators, and
computer janitors.

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Zikes
Isn't this what IBM Watson is being built to fix?

