Reinventing the Electronic Medical Record (EMR) Position We are making a national investment of billions of dollars to scale up the use of EMRs to improve

Reinventing the Electronic Medical Record (EMR)

Position

• We are making a national investment of billions of dollars to scale up the use of EMRs to improve the access, quality and cost of care in the US.

• There are seven major challenges to using our current products (EMR 1.0) to achieve that goal.

• Fortunately, we can meet all seven challenges but doing so requires a complete rethinking of products and approaches.

• We need to develop an EMR 2.0.

This presentation describes the challenges with scaling EMR 1.0 and how EMR 2.0 will meet them.

Copyright © 2009, New Value Streams Consulting LLC 2

Seven EMR 1.0 Challenges

1. Implementation Complexity

2. High Cost and Low Interoperability

3. Limited and Delayed Value

4. Lack of Cognitive Support

5. Information Sharing Disincentive

6. Improved Care Disincentive

7. Threaten Provider Business Model


1. Implementation Complexity

EMR 1.0

Implementations are long, complex and involve large software modules that cause significant disruptions to operations

EMR 2.0

Rearchitect from transaction-oriented modules to small components and services that can be implemented quickly and used as needed


2. High Cost and Low Interoperability

EMR 1.0

Costs are too large for many clinics and hospitals. Patient data is locked in as EMR 1.0 does not promote exchange between payers and providers

EMR 2.0

Use cloud computing to dramatically lower costs and achieve interoperability within the enterprise, across enterprises, regionally, nationally and globally (e.g. medical tourism)


3. Limited and Delayed Value

EMR 1.0

Benefits can take years to realize and are hard to measure

EMR 2.0

Focus first on creating value not simply turning paper forms into electronic documents (value informatics)


4. Lack of Cognitive Support

EMR 1.0

Does not provide natural support for strong situational awareness, making effective decisions or changing behaviors

EMR 2.0

Go from data to semantic content and knowledge to provide a world-class level of cognitive and behavior change support


5. Information Sharing Disincentive

EMR 1.0

Have to spend time capturing, using and sharing information with no direct benefit

EMR 2.0

Provides a fee for information service, to those that have vital information but do not directly receive a benefit from capturing, sharing or using it


6. Improved Care Disincentive

EMR 1.0

Sharing information and improving care will lower provider revenue

EMR 2.0

Create an electronic marketplace to implement P4P incentives to accelerate the adoption of best practices in preventative, acute and chronic care


7. Threatens Provider Business Model

EMR 1.0

Allows new entrants to influence patient’s consumption decisions and threatens providers business model. You are eating my lunch!

EMR 2.0

Offer forward thinking providers caught on the wrong side of the value migration an opportunity to reinvent


Recap of EMR 2.0 Solutions

• Develop a service-oriented architecture (SOA) for EMRs• Deliver EMR services from a cloud computing platform• Build high value applications from the cloud-based

services rather than automating forms and paper charts• Develop semantic or knowledge-based services that

directly support situational awareness, decision making and behavior change

• Provide a mechanism for determining, tracking and paying P4P incentives to support the information sharing and improved care needed to drive EMR 2.0 services

• Offer new information-based revenue opportunities to providers that face business model disruption

Documents

Reinventing the Electronic Medical Record (EMR) Position We are making a national investment of billions of dollars to scale up the use of EMRs to improve