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Barbara Duck

This is indeed a great topic and never did I think the time that I spent in the early days developing an EMR that what I learned then would have value now, but it does knowing how all the code goes together and the complexities. Oh gosh I remember those all nighters writing query after SQL query as 100 times you think you have it correct and formatted the way you want it and 100 times you don't..and so on.

The complexities today of course are much more than what I did as single developer and today of course to keep up with it you have teams of developers as a sole developer like me would die of exhaustion at the keyboard trying to keep up:)

I agree with you there's no big fire sale out there to rush CIOs out the door by any means but let me say this their pressure has surmounted as well. There's a lot of uncertainties out there and recently I talked about the ACA and what all are wanting to do to fix it. Well you can read this post if you want, but both parties can't seem to come to terms with the fact that the machines run the ACA so along with policy and changes, you better think about some code and development time too. Has the memory of Healthcare.Gov when it comes to code already escaped everyone:)


They talk about repeal and don't get any further but the code isn't going to come out and change the same way it went in:) I'm just a bottom liner that's been up to my ears in code and try to convey reality with all of this.

Now I also hear the political battle of de-certifying EMRs that won't interop. Frankly we are at the place in time to where it's a platform that sits on top of EMRs that will carry out this function and if the EMRs write an API to work with such, let them stay around as long as the rest of the needed functionality is there and it's not antiquated if you will.

I'll give you a link to Zoeticx and this is just that to where even legacy systems are ok and the interops are done on the fly, which means when the combination session is over, all medical records return back home to their domicile. Patients will love that by all means and you don't need the expensive HIEs; however you can take advantage of them as a data source if they are there.


In addition these videos at this link are really good, done by Pam over at the World Privacy Forum and they tell patients about how their records are stored and shared at an HIE..the only videos that I have seen that address this, so I blogged them.


Myself since we are post Blumenthal at the ONC, I don't understand why a clinical MD is running the show either as now with the complexities you need someone with data mechanics logic. This is not a personal attack at all and we have the same thing at other agencies too like the SEC for one example as without some data mechanics logic, they are lost. Nothing like having someone around that has first hand experience digging around in a lot of code if you get my drift.

Consumer watchdog came out and said the new Blue Cross HIE which is work in process was not defined properly enough and I agree with them from what I have read as well. The Watchdog is not always correct in technical matters as they ate it big with the data base for prescription drugs which was not ready to take on a big capacity until the IT work is done. That's what I talk about when i say data mechanics logic, so get it right and get the real story. Remember Heatlhcare.Gov, you don't push things out before their time.

By the way, if you never saw the interview, Classic Dr. Halamka from about a month ago with CXOTalk-he's right on as always and he has a lot of data mechanics, logic in what he does and says by comparison and is very candid and flat out blunt too when he needs to be:)


The EMR monsters just grew with adding more software on top of other software and that's the way the business works and you get a mess with a lot of complexities at some point and insurers did everyone one in with their payer input as well to even add more complexities.

So..stay tuned and lets see where platforms like Zoeticx go here as that's the really the answer, a platform with EMRs and APIs that connect.

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