Very perceptive, in my opinion.
I suspect that everyone here is so focused on getting a product out
that questions of interoperability are not given much consideration.
But it's surely true that people will shy away from using VistA if
they feel that they are locked in to a particular platform or
product, even if it is open source.
===
Gregory Woodhouse
[EMAIL PROTECTED]
"A practical man is a man who practices the errors of his
forefathers. -- Benjamin Disraeli
On Aug 30, 2005, at 4:30 PM, [EMAIL PROTECTED] wrote:
I'd like to hear everyone's thoughts about
http://www.computerworld.com/newsletter/0,4902,104195,0.html?nlid=AM
Network Effect
Opinion by Frank Hayes
AUGUST 29, 2005 (COMPUTERWORLD) - "I work for a hospital
management company
in the Midwest that works with 30 very small rural community
hospitals. Not
one of our hospitals is ready for electronic health records. They
are not
even close to giving up paper. I guarantee you there are more
hospitals that
do not have EHR than those that do."
This network manager who wrote to me is right. When I said a few
weeks back
[QuickLink 55837] that "hospitals have made the transition over the
past
decade" to EHR, I was wrong. True, many large health care
organizations have
put EHR in place. But the rest of the health care world has a big
challenge
ahead.
Wait, check that: A better way to say it is that because many
doctors and
small hospitals aren't using EHR, everyone in health care faces a big
challenge.
Why? It's the network effect. Remember Metcalfe's Law: The more
users who
can communicate with one another on a network, the more valuable
the network
is.
Sure, EHR can save some money internally for each organization that
implements it. But the big value comes when lots of organizations can
exchange medical records efficiently.
And the lack of widespread use of EHR actually adds cost for
organizations
that use it. Every time one of those small community hospitals sends a
patient to a big health care organization with actual paperwork,
that paper
has to be converted to electronic records. Then the EHR has to be
printed on
paper again for the patient's file when he goes back home.
That means we can't treat EHR as a competitive advantage that we
keep for
ourselves. We have to spread it around as widely as possible.
Otherwise we
can't realize the biggest benefits -- including the largest cost
savings.
That's not unique to EHR. For example, no company can get maximum
advantage
alone from RFID; everyone on the supply chain has to use it. And
Internet
retailing only works when all customers and suppliers use the same Web
protocols.
But that's not the way we're used to thinking about IT's benefits.
And it's
not the way we usually sell new IT initiatives to top management.
It's one
thing to say, "We need to adopt this technology to get an advantage
over the
rest of our industry." It's quite another to argue, "We need to get
the rest
of our industry to adopt this technology so we can maximize our
benefit from
it."
In the case of EHR, it's especially sticky: These are patients, not
products, so there's no chance of a Wal-Mart-style "adopt this or
we won't
buy from you" ultimatum.
But big health care organizations still have a big interest in
getting small
hospitals, clinics and medical practices on board with EHR. It's
the only
way to get a big-time payback from their own EHR spending.
Making that happen won't be easy. The costs of software, hardware,
implementation, training and running the systems aren't trivial.
Distributing less-expensive EHR software like Vista-Office is a
start, but
more will need to be done.
For big health care players, will that mean contributing
improvements to the
Vista-Office software? Partnering with small hospitals to train IT and
medical staff? Donating equipment? Lobbying for the health care
equivalent
of the Rural Electrification Act?
I don't know. But short of a real push, big health care
organizations won't
get the ROI they want from EHR. And as that network-manager reader
put it,
"those that do not have EHR will not be ready in the next few years
-- or
the next 10 years."
Incidentally, in response to readers who asked where to find Vista-
Office
EHR and the open-source OpenVista, try the Vista-Office Web site
(www.vista-office.org) and WorldVista (www.worldvista.org).
OpenVista is
available now; Vista-Office EHR is still scheduled to be out this
month.
Frank Hayes, Computerworld's senior news columnist, has covered IT
for more
than 20 years. Contact him at [EMAIL PROTECTED]
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