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Ok first statement here "programming is freaking difficult"..no offense meant but keep that thought:) Back in the early days I created an EMR myself so I know all about it and today they are a far cry from where we all started by all means.

When everything went to the web, it was time for me to quit developing an EMR as a sole developer as one person could no longer do it all, or die at the keyboard from exhaustion, that was another choice:)

When EMRs came out they were not bad and I know all about what we used to call "click wars" and that reducing the number of clicks and making use the screen real estate and it's hard and even harder now with more information flowing through.

Insurers screwed up the system and instead of being a tool for doctors, it became a tool for insurance billing with all the additional algorithmic formulas that had to work through. It was a natural process that billing would evolve out of an EMR but maybe no in the fashion that it did.

United Healthcare owns I think around 5 EMR companies, plus all their other stuff like revenue cycling and they even licensed that with Cerner and it became part of their overall program.

The interchange I do agree with is a joke and there's hot one in the works and this guy has it nailed with a platform that can sit on any EMR and provide a common user interface and when the connection is done, it drops off, really a good engineered design and will be heck of a lot cheaper than building all these data warehouses.

Here's my post when I did it just from reading about it the owners were all over calling me as I was the only one out there that understood it and again having been a coder helps a lot.


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