EMR have to many buttons, what a mess

http://mobihealthnews.com/2917/kibbe-successful-emrs-will-be-like-the-iphone-platform/comment-page-1/#comment-5771

Answer to this request for "iPhone like" EMR

What is being asked for, is a well designed system. Many EMR systems available today have been hacked together, not designed with Engineering principles. I hear these complains from both HIT and from Domain/caregivers experts. What is needed when creating any system is tried and true engineering process. Start with the domain experts, doctors, nurses, lab tech, etc. add an group of software system architects and develop the requirements. Then design a system based on requirement and build system. The domain experts and system architects also develop a test and acceptance plan that is used to determine if the system works per design. It takes both sides of the equation to build a good system, domain expertise and engineering.

This is the first generation of real EMRs. Like most new technologies the domain expert has a great idea and learns how to program a prototype (a few buttons) which evolves into a product. The products are introduced to the market, many more functions and more buttons are added until you have a mess. Second generation, the idea's are taken to the next level, this usually comes after an influx of money. Some companies start over using standard engineering practices. Other companies keep the original system and keep hacking away. Look how long it took Microsoft to get rid of DOS. Almost all software companies face these problems from time to time. Ebay started as a small program that was written in a guy's garage to sell his wife figurines.

The good new is that Enterprise system in HIT are relatively new and the market will wash out the bad EMR or they will redesign to meet the needs of their customers. The problem is that these systems are very expensive and it will cost us all to flesh them out. Make sure that when selecting such an important system that you have done your due diligence.

Jeff Brandt
CTO motionPHR mobile Personal Health Record for the iPhone
MyMobileMedBox for Android

Remote medicine

This is a reposted comment to telemedicine article in India where oncologist are providing medical to remote India.

This is the future of medicine, 10 years from now your doctor may be located thousands of miles from you. I have been discussing remote medicine with a surgeon friend of mine for several year, last year while providing services to the PGA tour he got a opportunity to visit a northern universities virtual surgery center. He was very excited with he told me of the realistic feel of selecting a tool from a screen and cutting into a cadaver. I envision the future of surgery to be similar to a self checkout line in the grocery store. You have 4 patients on operating tables with one surgeon and a anesthesiologist, the surgeons performing surgery are not on location. Today some eye surgery are done remotely with the surgeon in the next room with robotic gloves. The outcomes are proven to be better for this type of precision surgery.

It is fun to dream, see the future make the future.

Jeff Brandt - motionPHR for the iPhone

Not convinced about EMR?

When you have such a disruptive technology as EHR/EMR hit a vertical market such as Healthcare you are bound to have push back, and rightfully so. The early adopters are easy, then comes the convincing and the proof. I have a saying that I have been using for many years, "What is the best word processor on the market? The one you know.". Remember the last time you had to replace a favorite tool, whatever it was. The new one is not as comfortable, it is a piece of S... then you get to know it, use it more, it's not so bad, even better than an old friend. Jimmy Conners had the same problem in the 70's when he would not give up his old Wilson racket. Finally he did and he played better. He thought he needed that old racket to play well. It wasn't the racket, it is the person using it that really counts. Things change and EMR/EHR are here to stay, so embrace them, be a champion. You may as well.

Jeff Brandt
motionPHR for the iPhone
mymedbox for Android

Secuity and EMR, Will Cloud Help?

It will depend on management and their IT department. I was consulting for a hospital in Central Oregon that had 40 application running an 40 Microsoft machines to host. This is not an Enterprise system. The change to Enterprise Cloud will take time and training of desk top IT staff.
Cloud computing has been around for a very long time it is proven to work. It is basically client server or a WebApp. The security will always remain in the hands for the decision makers to know how to make the correct choices and implement the control policies. For laptops and desktops that do not have hard drives Cloud will provide much security. But again the implementation must be correct.

On the subject of EMR security, Cloud security can be very safe but you must do your homework on the hosting facility and their policies. Most EMR's are on a server in a closet in doctors offices or in the developer of the EMR offices. One of the biggest risk is server snatching, when at ID thief breaks into the Doctors office and just takes the servers.

Jeff Brandt MotionPHR Personal Health Record for the iPhone
myMedBox PHRlite for Android

June 15,

repost: which Smartphone will lead

Our company Communication Software Inc. develops Medical apps for the iPhone and Android. We were deeply involved in development of the first Internet Boom in the 90's were I saw the same situation as the apps today. The first websites as are the apps of today were whatever anyone thought were cool with very little business planing to back them. Also, if you remember the 90's online businesses were offering non sustainable business models, example pricing models that lost money which is the same in today's app market. Most apps are free and with many of these; free is not cheap enough. This will change as the market matures and these poor business models companies and developers disappear.

As for which phone will lead the market in the future, it is hard to tell. Like so many new ideas, the leader fail behind as followers learn from the leader mistakes.

I believe Android is the wild card. It is open source and the development is in Java, the OS is free and manufactures are getting behind the platform because of cost. There are 18 new Android phones to be released this year. One thing you can count on it is going to be a good fun ride so hang on.

Jeff Brandt
motionPHR a Personal Health Record for the iPhone
myMedBox a Personal Health Record for Android/Google Phone

Android at this place and Time

You can ask almost anyone on the street; what is an iPhone? In most cases they can tell you. But when asking if they are familiar with the Android Phone, most likely they are not. They might have heard of the Google phone or G1 but not in most cases. This is the first problem with the platform, name recognition. I read articles about smartphones every week in publications like the Wall Street Journal. They always mention the iPhone and Blackberry but almost never the Google/Android/G1 phone. If consumers don't know what it is they surely will not buy it.

As for the platform itself, it is young and Open Source. I have a love hate relationship with Open Source. I have developed many enterprise projects with Open Source and I can tell you this, it is not for free. I have a nickname for it, "Open Sore". But if a company like SUN or IBM gets behind the Android project like they did with Java, Android will be a great platform to build a business upon. Motorola, the developer are listening.

Google produced a really cool platform, Android, and they turned it over to Open Source, which I commend them and think it was in their best interest a smart thing to do. Developing smartphone OS is not Google's primary business. It will take a company/s to lead Android to the next level of acceptance. I still do not understand why Microsoft didn't use Android as the base in their latest release of MSMobile, but I don't understand why they didn't build MS 7 on Linux, oh whatever, I shouldn't get started on that.

As for the Android platform itself, it still has a ways to go before reaching maturity, both in the OS and Tools. As for the Android OS on the phone as a consumer, I love it. I carry both the iPhone and Android phones, both have some great features and Apps. Android Apps have the potential to be much more powerful and feature rich then the iPhone because the features in the SDK, Open Source and Apples heavy restrictions. I mention the word potential because most of the apps to date on the Android are ok at best.

Currently, there is not a good App store for Android on the web that has a reasonable pricing stucture. iTunes blows Google Market away. Google Market doesn't even have a real web store to purchase Apps. Secondary Web stores like Handango want 40% of the profit leaving little for the developer. Low price point expectation and noise from the crowded market has made Enterprise applications simply out of the question. Businesses normally do not buy Enterprise software at the same place that sell iFart Apps and games. I expect these problems will be worked out in time.

I see the same thing happening in the Apps market that happened in the late 1990's Internet Boom/Bust. A lot of people were in the business that new nothing about business or creating Web apps. It will just take a bit of time to flush out the market.

I envision three real players in the near future, Blackberry, they have the business market for now because they can communicate with Outlook, iPhone, they have the entertainment market and Apple like it that way. They also have the coolness factor Android, they have a chance to take the Enterprise and business market for verticals such as financial and health care. But who knows, there may be ten more OS platforms next year, only time will tell.

Jeff
motionPHR.com
mymedbox.com

Starting to see where Android could take the Market

Motorola is betting the farm on Android which is great for Android manufacture and developers. Motorola like Apple need to make a profit off of their Smartphone production. Motorola is just the type of company that Android needs to move up the ladder of recognition and sales.

iPhone is a great platform but Apple has had many stumbles on the way to the top, especially with the development community. What I have learn from the early days at CyberCash it is not alway best to be first. Most non-proprietary developers (java, open source) want to have the freedom to express their art in there development. A tightly closed environment such as Apple stifles developers ideas and best products. On the other side of the coin, Apples closed environment has help them to produce good stable products. Motorola may have the blend of both worlds. Motorola has the tools an oportunity to lead the smartphone market. It will depend on if they can get back to their roots, building good products, with good support. I hope they also learned their lessons with the Iridium Project that you cannot move all of your development offshore and keep control. It will also depend on their marketing, Apple hands down has the marketing down.

We will have to wait and see what happens. As a developer of products for both the iPhone and Android, May the better phone win. As a developer of both platforms I will have to go with Android.