The EMR Challenge, Part 1 - Definition

Let's face it, no comprehensive EMR (which includes adequate practice analytics, registry reporting, connections to personal health records, etc.) vendor has an adequate implementation process that will allow for >90% of users to be able to adopt the advanced functions. What makes this especially challenging is that few adequately understand what adequate implementation planning/guidance even means. So, the current situation is that the EMRs that clinicians are actually using at the point of care are not comprehensive (e.g. SOAPware v4 and similar) because these require less implementation planning/guidance than more comprehensive/capable EMRs (i.e. SOAPware 2010). However, emerging EMR requirements (being met by SOAPware 2010) are much more complex and demanding.
Emerging, comprehensive EMR functionality requirements (mostly set by non-users of EMR) often exceed what EMR users can initially adopt without adverse disruptions to patient care. Therefore, clinician EMR users tend to gravitate into one of 3 groups:
1. Use simple EMR, as paper-behind-glass repository of narratives and free text, and remain unable to meet emerging requirements for more comprehensive use.
2. Use comprehensive EMR to capture more structured data and accept adverse practice disruptions (average 30% loss in productivity, reduced patient interaction, clinicians become data trolls).
3. Acquire comprehensive EMR, and accept clinicians will not actually use it at the point of care. They continue dictation/paper and leave EMR interaction to others.

My current career passion is to oversee the creation of a suite of comprehensive EMR implementation products/services allowing >90% of clinicians to adopt advanced, comprehensive EMR and advanced H.I.T. functionality at the point of care while increasing everyone's satisfaction and productivity. The scope of the challenge is about to be more clear once the ARRA "meaningful use" criteria are finalized. It appears these are likely to be complimentary to the specifications for the Patient-Centered Medical Home (PCMH) specified by NCQA.